A speech corpus of Quechua Collao for automatic dimensional emotion recognition.

Automatic speech emotion recognition is an important research topic for human-computer interaction and affective computing. Over ten million people speak the Quechua language throughout South America, and one of the most known variants is the Quechua Collao one. However, this language can be considered a low resource for machine emotion recognition, creating a barrier for Quechua speakers who want to use this technology. Therefore, the contribution of this work is a 15 hours speech corpus in Quechua Collao, which is made publicly available to the research community. The corpus was created from a set of words and sentences explicitly collected for this task, divided into nine categorical emotions: happy, sad, bored, fear, sleepy, calm, excited, angry, and neutral. The annotation was performed on a 5-value discrete scale according to 3 dimensions: valence, arousal, and dominance. To demonstrate the usefulness of the corpus, we have performed speech emotion recognition using machine learning methods and neural networks.

Biological control of Fasciola hepatica eggs with the Pochonia chlamydosporia fungus after passing through the cattle gastrointestinal tract.

Fasciolosis is a disease caused by Fasciola hepatica responsible for causing significant losses in livestock. This study aimed to evaluate the Pochonia chlamydosporia fungus (isolate VC1) on F. hepatica eggs after passing through the cattle gastrointestinal tract. For this evaluation, 1 g pellet was given in sodium alginate matrix per kilogram live weight containing 25% of fungal mycelium from isolate VC1 per animal. Twelve animals were used, six treated and six untreated (control). Some stool samples were collected from the groups of treated and control animals, at the times of 12, 18, 24, 48, 72, and 96 h after the pellets' administration. Then, from each stool sample of treated and control groups, 2 g was placed in a Petri dish of 9 cm in diameter, containing 2% water-agar and 1,000 eggs of F. hepatica. It was observed that the fungus was effective in preying upon the eggs in the samples recovered at all of the schedules starting at 12 h. Furthermore, differences were observed (p < 0.01) in the destruction of eggs in the Petri dishes in the treated group compared with the control group. The ovicidal effect was observed after 7 days of interaction. The ovicidal P. chlamydosporia fungus was effective in destroying F. hepatica eggs; therefore, it is suggested that this fungus could be employed as agent for the control of helminth eggs.

Current trends in altitude training.

Recently, endurance athletes have used several novel approaches and modalities for altitude training including: (i) normobaric hypoxia via nitrogen dilution (hypoxic apartment); (ii) supplemental oxygen; (iii) hypoxic sleeping devices; and (iv) intermittent hypoxic exposure (IHE). A normobaric hypoxic apartment simulates an altitude environment equivalent to approximately 2000 to 3000m (6560 to 9840ft). Athletes who use a hypoxic apartment typically 'live and sleep high' in the hypoxic apartment for 8 to 18 hours a day, but complete their training at sea level, or approximate sea level conditions. Several studies suggest that using a hypoxic apartment in this manner produces beneficial changes in serum erythropoietin (EPO) levels, reticulocyte count and red blood cell (RBC) mass, which in turn may lead to improvements in postaltitude endurance performance. However, other studies failed to demonstrate significant changes in haematological indices as a result of using a hypoxic apartment. These discrepancies may be caused by differences in methodology, the hypoxic stimulus that athletes were exposed to and/or the training status of the athletes. Supplemental oxygen is used to simulate either normoxic (sea level) or hyperoxic conditions during high-intensity workouts at altitude. This method is a modification of the 'high-low' strategy, since athletes live in a natural terrestrial altitude environment but train at 'sea level' with the aid of supplemental oxygen. Limited data regarding the efficacy of hyperoxic training suggests that high-intensity workouts at moderate altitude (1860m/6100ft) and endurance perfor- mance at sea level may be enhanced when supplemental oxygen training is utilised at altitude over a duration of several weeks. Hypoxic sleeping devices include the Colorado Altitude Training (CAT) Hatch (hypobaric chamber) and Hypoxico Tent System (normobaric hypoxic system), both of which are designed to allow athletes to sleep high and train low. These devices simulate altitudes up to approximately 4575 m/15006 ft and 4270 m/14005 ft, respectively. Currently, no studies have been published on the efficacy of these devices on RBC production, maximal oxygen uptake and/or performance in elite athletes. IHE is based on the assumption that brief exposures to hypoxia (1.5 to 2.0 hours) are sufficient to stimulate the release of EPO, and ultimately bring about an increase in RBC concentration. Athletes typically use IHE while at rest, or in conjunction with a training session. Data regarding the effect of IHE on haematological indices and athletic performance are minimal and inconclusive.

Self-reported symptoms and exercise-induced asthma in the elite athlete.

PURPOSE: The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes. METHODS: Elite athletes (N = 158; 83 men and 75 women; age: 22 +/- 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire. RESULTS: Resting FEV1 values were above predicted values (114--121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25--75% and PEF to be -7%, -12.5%, and -18%, respectively. CONCLUSION: Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete's history of asthma symptoms.

Incidence of exercise-induced bronchospasm in Olympic winter sport athletes.

PURPOSE: The purpose of this project was to determine the incidence of exercise-induced bronchospasm (EIB) among U.S. Olympic winter sport athletes. METHODS: Subjects included female and male members of the 1998 U.S. Winter Olympic Team from the following sports: biathlon, cross-country ski, figure skating, ice hockey, Nordic combined, long-track speedskating, and short-track speedskating. Assessment of EIB was conducted in conjunction with an "actual competition" (Olympic Trials, World Team Trials, World Cup Event, U.S. National Championships) or a "simulated competition" (time trial, game), which served as the exercise challenge. Standard spirometry tests were performed preexercise and at 5, 10, and 15 min postexercise. An athlete was considered EIB-positive based on a postexercise decrement in FEV1 > or = 10%. RESULTS: For the seven sports evaluated on the 1998 U.S. Winter Olympic Team, the overall incidence of EIB across all sports and genders was 23%. The highest incidence of EIB was found in cross-country skiers, where 50% of the athletes (female = 57%; male = 43%) were diagnosed with EIB. Across the seven sports evaluated, the prevalence of EIB among the female and male athletes was 26% and 18%, respectively. Among those individuals found to be EIB-positive were athletes who won a team gold medal, one individual silver medal, and one individual bronze medal at the Nagano Winter Olympics. CONCLUSIONS: These data suggest that: 1) EIB is prevalent in several Olympic winter sports and affects nearly one of every four elite winter sport athletes; 2) the winter sport with the highest incidence of EIB is cross-country skiing; 3) in general, EIB is more prevalent in female versus male elite winter sport athletes; and 4) athletes may compete successfully at the international level despite having EIB.

Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge.

PURPOSE: The purpose of this study was to compare a laboratory based exercise challenge (LBC) to a field based exercise challenge (FBC) for pulmonary function test (PFT) exercise-induced asthma (EIA) screening of elite athletes. METHODS: Twenty-three elite cold weather athletes (14 men, 9 women) PFT positive for EIA (FBC screened) served as subjects. Twenty-three gender and sport matched controls (nonasthmatics) were randomly selected to establish PFT reference values for normal elite athletes. Before FBC, athletes completed a medical history questionnaire for EIA symptoms. FBC evaluations consisted of baseline spirometry, actual or simulated competition, and 5, 10, and 15 min postexercise spirometry. PFT positive athletes were evaluated in the laboratory using an exercise challenge simulating race intensity (ambient conditions: 21 degrees C, 60% relative humidity). PFT procedures were identical to FBC. RESULTS: 91% of PFT positive and 48% of PFT normal athletes reported at least one symptom of EIA, with postrace cough most frequent. Baseline spirometry was the same for PFT positives and normal controls. Lower limit reference range (MN - 2 SD) of FEV1 for controls suggests that postexercise decrements of greater than approximately -7% indicate abnormal airway response in this population. Exercise time duration did not effect bronchial reactivity; 78% of FBC PFT positives were PFT normal post-LBC. CONCLUSION: Self-reported symptoms by elite athletes are not reliable in identifying EIA. Reference range criterion for FEV1 decrement in the elite athlete postexercise contrasts current recommended guidelines. Moreover, a large number of false negatives may occur in this population if EIA screening is performed with inadequate exercise and environmental stress.

Effect of altitude training on serum creatine kinase activity and serum cortisol concentration in triathletes.

In this investigation we evaluated the effect of a 5-week training program at 1860 m on serum creatine kinase (CK) activity and serum cortisol concentration in national-caliber triathletes for the purpose of monitoring the response to training in a hypobaric hypoxic environment. Subjects included 16 junior-level female (n = 8) and male (n = 8) triathletes who were training for the International Triathlon Union (ITU) World Championships. After an initial acclimatization period, training intensity and/or volume were increased progressively during the 5-week altitude training camp. Resting venous blood samples were drawn at 0700 hours following a 12-h overnight fast and were analyzed for serum CK activity and serum cortisol concentration. Subjects were evaluated before [7-10 days pre-altitude (SL 1)] and after [7-10 days post-altitude (SL 2)] the 5-week training camp at 1860 m. At altitude, subjects were evaluated within 24-36 h after arrival (ALT 1), 7 days after arrival (ALT 2), 18 days after arrival (ALT 3), and 24-36 h prior to leaving the altitude training camp (ALT 4). A repeated-measures analysis of variance was used to evaluate differences over time from SL 1 to SL 2. Compared to SL 1, serum CK activity increased approximately threefold (P < 0.05) within the initial 24-36 h at altitude (ALT 1), and increased by an additional 70% (P < 0.05) after the 1st week of altitude training (ALT 2). Serum CK activity remained significantly elevated over the duration of the experimental period compared to pre-altitude baseline levels. Serum cortisol concentration was increased (P < 0.05) at the end of the 5-week altitude training period (ALT 4) relative to SL 1, ALT 1 and ALT 3. These data suggest that: (1) the initial increase in serum CK activity observed in the first 24-36 h at altitude was due primarily to acute altitude exposure and was independent of increased training intensity and/or training volume, (2) the subsequent increases in serum CK activity observed over the duration of the 5-week altitude camp were probably due to the combined effects of altitude exposure and increased training load, and (3) the increase in serum cortisol concentration observed at the end of the altitude training camp reflects the additive effect of 5 weeks of altitude exposure in combination with a progressively increased training intensity and/or volume.

A kinematic study of the cervical spine before and after segmental arthrodesis.

STUDY DESIGN: The acute kinematic consequence of segmental arthrodesis in the cervical spine on the remaining open motion segments was studied in a cadaveric model. OBJECTIVES: To evaluate the distribution of motion across unfused cervical motion segments after a segmental arthrodesis. The applied load was determined as a function of arthrodesis length and level by using a fixed range of motion for the cervical spine (C2-T1). SUMMARY OF BACKGROUND DATA: An increased incidence of degenerative disease may exist at the levels immediately adjacent to a cervical arthrodesis as a result of alteration in biomechanical behavior at these levels. METHODS: One-, two-, and three-level fusions were simulated in multilevel ligamentous human cervical spines. Specimens were tested nondestructively through a 30 degrees range of sagittal plane rotation. Motion was recorded using three-dimensional stereophotogrammetry. Sagittal plane rotation of each motion segment in the fusion models was compared with the corresponding rotation in the unfused specimen. RESULTS: In the C2-C4 fusion, the increase in motion at C5-C6 was statistically less (P < 0.05) than the increase at C7-T1. In the C2-C5 fusion, the increase in motion at C5-C6 was statistically less (P < 0.05) than the increases at C6-C7 and C7-T1. For each of the five other fusion types tested, no statistical differences existed between the increases in sagittal rotation at any of the open motion segments. The bending moment necessary to produce 30 degrees of sagittal rotation increased nonlinearly as the number of motion segments fused increased. CONCLUSIONS: Under what was considered a realistic loading paradigm, sagittal plane rotation was not increased disproportionately at the motion segments immediately adjacent to a segmental arthrodesis in the cervical spine. The nonlinear rise in applied bending moment to achieve constant displacement was characteristic of the behavior of the ligaments and intervertebral discs throughout the spine as they underwent increasing deformation.

Physiological profiles of elite off-road and road cyclists.

There are minimal scientific data describing international caliber off-road cyclists (mountain bikers), particularly as they compare physiologically with international caliber road cyclists. Elite female (N = 10) and male (N = 10) athletes representing the United States National Off-Road Bicycle Association (NORBA) Cross-Country Team were compared with elite female (N = 10) and male (N = 10) athletes representing the United States Cycling Federation (USCF) National Road Team. Submaximal and maximal exercise responses were evaluated during the "championship" phase of the training year when athletes were in peak condition. All physiological tests were conducted at 1860 m. Among the female athletes, physiological responses at lactate threshold (LT) and during maximal exercise (MAX) were similar between NORBA and USCF cyclists with two exceptions: 1) USCF cyclists demonstrated a significantly greater (P < 0.05) absolute (16%) and relative (10%) maximal aerobic power, and 2) MAX heart rate was significantly higher (P < 0.05) for the USCF athletes (6%). Among the male athletes, physiological responses at LT and MAX were similar between NORBA and USCF cyclists with two exceptions: 1) USCF cyclists produced significantly greater (P < 0.05) absolute (18%) and relative (16%) power at LT, and 2) USCF cyclists produced significantly greater (P < 0.05) absolute (12%) and relative (10%) power at MAX. These data suggest that, in general, elite off-road cyclists possess physiological profiles that are similar to elite road cyclists.

Influence of water run training on the maintenance of aerobic performance.

The purpose of this study was to examine the effect of a 6-wk deep water running program on the maintenance of cardiorespiratory performance (VO2max, ventilatory threshold, running economy); metabolic measurements of blood glucose, blood lactate, and plasma norepinephrine; and body composition. Sixteen trained male runners (VO2max = 58.6 +/- 3.6 ml.kg-1.min-1) were assigned to one of two groups matched by VO2max, treadmill run (R) or water run (WR). Subjects participated in their respective training programs, which consisted of workouts of a) 30 min at 90-100% VO2max and b) 60 min at 70-75% VO2max alternated daily for 5 d.wk-1. Following 6 wk of workouts, no significant intra- or intergroup differences were observed for treadmill VO2max for R (pre = 58.4 +/- 2.3, post = 60.1 +/- 3.6 ml.kg-1.min) and WR (pre = 58.7 +/- 4.7, post = 59.6 +/- 5.4 ml.kg-1.min-1). Similarly, ventilatory threshold was unaltered in R (pre = 47.5 +/- 1.8, post = 48.2 +/- 3.3 ml.kg-1.min-1) and WR (pre = 46.5 +/- 6.4, post = 47.4 +/- 6.7 ml.kg-1.min-1), nor were there any changes in running economy in R (pre = 48.4 +/- 2.3, post = 48.9 +/- 2.0 ml.kg-1.min-1 at 255 m.min-1) and WR (pre = 51.8 +/- 2.0, post = 48.9 +/- 2.2 ml.kg-1.min-1 at 255 m.min-1). No significant differences were observed within or between groups for maximal blood glucose, blood lactate, and plasma norepinephrine concentration as well as for body composition indices. It was concluded that deep water running may serve as an effective training alternative to landbased running for the maintenance of aerobic performance for up to 6 wk in trained endurance athletes.

Anterior stabilization of thoracolumbar burst fractures using the Kaneda device: a preliminary report.

Anterior decompression and fusion is a valuable technique in the treatment of thoracolumbar burst fractures. Anterior instrumentation has evolved to correct deformity and stabilize the spinal segments during decompression and bone grafting as a single-stage procedure. One anterior device developed by Kaneda has been used in our institution since 1989. This study is an initial review of our experience with this instrumentation. Anterior decompression and fusion augmented with the Kaneda device was performed in 20 patients with thoracolumbar burst fractures. Timing of surgery was early (< 15 days) in 13 patients, intermediate (16 to 120 days) in 2, and delayed (> 121 days) in 5. Sixteen patients were neurologically intact (Eismont grade D), 3 with distal weakness (Eismont grade B or C) and 1 with complete paraplegia (Eismont grade A). All patients with deficits recovered one Eismont grade after anterior decompression and fusion. Complications included pulmonary problems in 2 patients, a thoracic duct laceration requiring ligation, and a sympathectomy effect of the lower extremity. One patient had a pulmonary embolus and developed a hematoma at the graft harvest site while on anticoagulants with resultant meralgia paresthetica. There have been three screw failures and one definite pseudarthrosis. Anterior decompression and fusion supplemented by the Kaneda device was performed on 20 patients with thoracolumbar burst fractures. The average correction of kyphosis was approximately 50% acutely, with loss of approximately 50% of correction at follow up. In some patients, coronal plane deformity was created by the device. No effect on neurologic recovery could be shown with this small series. Perioperative complication rate was 30%, and 1 patient developed pseudarthrosis.

Pedicular transvertebral screw fixation of the lumbosacral spine in spondylolisthesis. A new technique for stabilization.

Controversy exists about which method is most appropriate for treating moderate- to high-grade spondylolisthesis and symptomatic pseudarthrosis. The authors report preliminary results of pedicular transvertebral screw fixation, a new technique for stabilizing the lumbosacral junction in moderate- to high-grade spondylolisthesis. Using this technique, fusion was successful in three patients, two with an established pseudarthrosis. Pedicular transvertebral screw fixation provides immediate three-column stabilization of the lumbosacral junction. The technique is safe, effective, and employs instrumentation common to spine surgery. Its use in high-grade slips makes the technique more simple to perform than other methods of lumbosacral stabilization.

Penetration of cefprozil into tonsillar and adenoidal tissues.

Penetration of cefprozil into tonsillar and/or adenoidal tissues was investigated for patients undergoing tonsillectomy and/or adenoidectomy. A total of 29 patients ranging in age from 2 to 14 years participated in the study. The tonsils and/or the adenoids were removed at times ranging from 0.33 to 3.17 h after oral administration of a dose of either 7.5 or 20 mg/kg of body weight. A blood sample was also collected as soon as the tissue sample was removed. Plasma, tonsil, and adenoid samples were analyzed for cis and trans isomers of cefprozil by high-performance liquid chromatographic assays. The concentrations of the cis isomer of cefprozil in plasma ranged from 0.60 to 9.87 micrograms/ml at the 7.5-mg/kg dose level and from 1.04 to 20.40 micrograms/ml at the 20-mg/kg dose level. The corresponding concentrations of the cis isomer in tonsil tissue ranged from 0.48 to 2.42 micrograms/g and from 1.00 to 4.29 micrograms/g, respectively. The corresponding concentrations of the cis isomer in adenoid tissue ranged from 0.40 to 4.20 micrograms/g and from 1.74 to 4.94 micrograms/g, respectively. The concentrations of the trans isomer were about 1/10 of those observed for the cis isomer. The median ratios of the cefprozil concentration in tonsillar tissue to that in plasma were 0.37 and 0.47 for patients receiving a 7.5- or a 20-mg/kg oral dose of cefprozil, respectively. The corresponding median ratios for the adenoidal tissue were 0.46 and 0.82, respectively. The cefprozil concentrations in either the tonsillar or the adenoidal tissue at both dose levels over 3.17 h after dosing are much higher than the MICs for common pathogens which cause pharyngitis or tonsillitis.

Anterior cervical corpectomy for the treatment of complex cervical lesions.

Instability and stenosis of the cervical spine have been treated by posterior decompression and anterior decompression with fusion. In this study the authors evaluate the results obtained in 31 patients who underwent anterior cervical corpectomy for compressive or unstable lesions of the cervical spine. Operative level, preoperative and postoperative symptoms and physical findings were assessed. Twenty-seven patients had preoperative neurologic symptoms and signs, including alterations in sensation, motor findings and reflexes. The average follow-up was 12 months, average number of disc spaces excised was 2.5 and average number of vertebral bodies excised was 1.6. With respect to relief of pain, results were good or excellent in 27 patients. All patients but one had union of the bone graft. No neurologic deterioration occurred. The authors believe that patients with compressive lesions of the cervical spine can benefit from anterior cervical corpectomy with fusion and that complications are minimal.

Influence of carbohydrate ingestion on blood glucose and performance in runners.

Ten trained male runners performed a treadmill exercise test at 80% VO2max under two experimental conditions, carbohydrate (CHO, 7% carbohydrate) and placebo (P), to determine the effect of carbohydrate ingestion on endurance performance (treadmill run time), blood glucose concentration, respiratory exchange ratio (RER), and subjective ratings of perceived exertion (RPE). Treatment order was randomized and counterbalanced and test solutions were administered double-blind. Ingestion took place 5 min preexercise (250 ml) and at 15-min intervals during exercise (125 ml). Performance was enhanced by 29.4% (p < 0.05) during CHO (115 +/- 25 min) compared to P (92 +/- 27 min). Blood glucose concentration was significantly greater during CHO (5.6 +/- 0.9 mM) relative to P (5.0 +/- 0.7 mM). There was a significant increase in mean RER following CHO ingestion (.94 +/- .01) compared to P (.90 +/- .01). Average RPE was significantly less during CHO (14.5 +/- 2.3) relative to P (15.4 +/- 2.4). These data suggest that time to exhaustion of high-intensity treadmill exercise is delayed as a result of carbohydrate ingestion and that this effect is mediated by favorable alterations in blood glucose concentration and substrate utilization.

Oral absolute bioavailability and intravenous dose-proportionality of cefprozil in humans.

The absolute bioavailability (F) and dose proportionality of cefprozil were investigated in a parallel design study with an embedded two-way crossover leg. Twenty-four healthy male subjects divided into 3 dosing groups received a single 250-, 500-, or 1000-mg dose of cefprozil by a 30-minute intravenous infusion. Subjects assigned to the 500-mg dose group also received a 500-mg oral dose of cefprozil in crossover manner with a wash-out period of 7 days between each treatment. Cefprozil consists of cis and trans isomers in an approximate 90:10 ratio. Serial blood and urine samples were collected and analyzed for the concentrations of the cis and trans isomers of the cephalosporin using high-pressure liquid chromatographic assay with UV detection methods. After the 250-, 500-, and 1000-mg intravenous administration of cefprozil, the peak concentrations were 13.2, 26.0, and 48.5 micrograms/mL, and area under the plasma concentration versus time profiles were 17.2, 31.4, and 58.1 micrograms.hour/mL, respectively, for the cis isomer increasing in a dose proportional manner. Total body clearance, renal clearance, and volume of distribution at steady state, adjusted for body weight, were not significantly different among all groups. Mean residence time, elimination half-life, and urinary recovery were invariant with the dose. Based on the plasma and urine data, the estimates of F were 89% and 94% for the cis isomer, respectively. The plasma concentrations of the trans isomer were about 1/10th of the cis isomer, and all parameters were similar to those observed for the cis isomer. In summary, cefprozil exhibits linear pharmacokinetics and is essentially completely absorbed after oral administration.

Safety profile of cefprozil.

The clinical and laboratory safety of cefprozil was analyzed with data from 4,227 patients who received the drug in North American and European clinical efficacy trials. Of these patients, 3,016 adults and children received capsules or tablets, while 1,211 patients (mostly children) were treated with cefprozil suspension. Cefprozil was used in single-daily or twice-daily dosing regimens for treatment of infections of the upper and lower respiratory tracts, sinuses, middle ear, urinary tract, and skin and skin structure. The incidence of adverse clinical events and laboratory abnormalities was similar to that associated with use of other oral cephalosporins. Gastrointestinal adverse effects were the predominant adverse clinical event, although the incidence of diarrhea with cefprozil was much lower than that with cephalosporins that are less well absorbed. The data confirm the safety of cefprozil in both adult and pediatric patients.

Drill sleeve for pedicle screw fixation.

Pedicle screw fixation is a popular method of fixation of the spine. Placement of screw and prevention of injury are surgeon dependent. We describe an easily made drill sleeve and depth gauge to assist in the preparation of the vertebral pedicle for pedicle screw application. Use of this device will help prevent soft tissue injury and overpenetration of the drill in the vertebral body.

Cefprozil versus cefaclor in the treatment of mild to moderate skin and skin-structure infections. The Cefprozil Multicenter Study Group.

In a multicenter study, 598 patients with skin or skin-structure infections were randomly assigned to receive 500 mg of cefprozil once daily (or 20 mg/kg once daily) or 250 mg of cefaclor three times daily (or 20 mg/kg daily in three equal doses) for 5 to 10 days. Treatment was evaluated in 212 cefprozil-treated patients and in 210 cefaclor-treated patients. The patients were aged 2 to 99 years (mean, 28 years) and their primary diagnoses were impetigo (in 99 patients), pyoderma (in 98), superficial abscess (in 70), and cellulitis (in 64). A satisfactory clinical response was found in 93% of the cefprozil-treated patients and in 92% of the cefaclor-treated patients, the pathogens were eradicated in 91% and 89%, and overall treatment was rated effective in 87% of both groups. Adverse clinical events were reported by 5% of the patients in both groups; one cefprozil-treated patient and three cefaclor-treated patients withdrew from treatment because of adverse events. It is concluded that cefprozil administered once daily is as effective and safe as cefaclor administered three times daily in the treatment of mild to moderate skin and skin-structure infections.

Excretion of cefprozil into human breast milk.

The excretion of cefprozil into breast milk in nine healthy, lactating female subjects was investigated. Each subject received a single 1,000-mg oral dose of cefprozil consisting of cis and trans isomers in an approximately 90:10 ratio. Serial blood, urine, and breast milk samples were collected and analyzed for the concentrations of the cis and trans isomers by a specific high-pressure liquid chromatography-UV assay. The mean pharmacokinetic parameters for both isomers were essentially the same. The mean peak concentrations in plasma for the cis isomer were 14.8 micrograms/ml, and the area under the concentration curve was 54.8 micrograms.h/ml. The mean values of elimination half-life, renal clearance, and urinary excretion for the cis isomer were 1.69 h, 164 ml/min, and 60%, respectively. The mean concentrations in milk of the cis isomer over a 24-h period ranged from 0.25 to 3.36 micrograms/ml, with the maximum concentration appearing at 6 h after dosing. The average maximum concentration in milk of the trans isomer was less than 0.26 micrograms/ml. The concentrations of the trans isomer in plasma and in breast milk were about 1/10 of those for the cis isomer. Less than 0.3% of the dose was excreted in breast milk for both isomers of cefprozil. Even if one assumes that the concentration of cefprozil in milk remains constant at 3.36 micrograms/ml (the highest concentration of cefprozil observed in breast milk), an infant ingesting an average of 800 ml of milk per day will be exposed to a maximum amount of about 3 mg of cefprozil per day. This value represents about 0.3% of the maternal dose. Low excretion of cefprozil in breast milk and the excellent safety profile of cefprozil suggest that this cephalosporin may be administered to nursing mothers when indicated.