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McGuire SP, Anderson MP, Maatman TK, Roch AM, Butler JR, Ceppa EP, House MG, Nakeeb A, Nguyen TK, Schmidt CM, Zyromski NJ. Opioid analgesia in necrotizing pancreatitis: Incidence and timing of a hidden crisis. Am J Surg 2022; 225:927-930. [PMID: 36792453 DOI: 10.1016/j.amjsurg.2022.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Rates of opioid usage during necrotizing pancreatitis (NP) disease course are unknown. We hypothesized that a significant number of NP patients were prescribed opioid analgesics chronically. METHODS Single institution IRB-approved retrospective study of 230 NP patients treated between 2015 and 2019. RESULTS Data were available for 198/230 (86%) patients. 166/198 (84%) were discharged from their index hospitalization with a prescription for an opioid. At the first clinic visit following hospitalization, 110/182 (60%) were using opioids. Six months after disease onset, 72/163 (44%) continued to require opioids. At disease resolution, 38/144 (26%) patients remained on opioid medications. The rate of active opioid prescriptions at six months after disease onset declined throughout the period studied from 68% in 2015 to 39% in 2019. CONCLUSIONS Opioid prescriptions are common in NP. Despite decline over time, 1 in 4 patients remain on opioids at disease resolution. These data identify an opportunity to adjust analgesic prescription practice in NP patients.
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Affiliation(s)
- S P McGuire
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M P Anderson
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T K Maatman
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A M Roch
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J R Butler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - E P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M G House
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Nakeeb
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T K Nguyen
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C M Schmidt
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - N J Zyromski
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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Maatman TK, Westfall-Snyder JA, Ceppa EP, House MG, Nakeeb A, Nguyen TK, Schmidt CM, Zyromski NJ. Necrotizing Pancreatitis from Hypertriglyceridemia: More Severe Disease? Dig Dis Sci 2021; 66:4485-4491. [PMID: 33464454 DOI: 10.1007/s10620-020-06766-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 12/06/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Necrotizing pancreatitis (NP) is caused by hypertriglyceridemia (HTG) in up to 10% of patients. Clinical experience suggests that HTG-NP is associated with increased clinical severity; objective evidence is limited and has not been specifically studied in NP. AIM The aim of this study was to critically evaluate outcomes in HTG-NP. We hypothesized that patients with HTG-NP had significantly increased severity, morbidity, and mortality compared to patients with NP from other etiologies. METHODS A case-control study of all NP patients treated at a single institution between 2005 and 2018 was performed. Diagnostic criteria of HTG-NP included a serum triglyceride level > 1000 mg/dL and the absence of another specific pancreatitis etiology. To control for differences in age, sex, and comorbidities, non-HTG and HTG patients were matched at a 4:1 ratio using propensity scores. Outcomes were compared between non-HTG and HTG patients. RESULTS A total of 676 NP patients were treated during the study period. The incidence of HTG-NP was 5.8% (n = 39). The mean peak triglyceride level at diagnosis was 2923 mg/dL (SEM, 417 mg/dL). After propensity matching, no differences were found between non-HTG and HTG patients in CT severity index, degree of glandular necrosis, organ failure, infected necrosis, necrosis intervention, index admission LOS, readmission, total hospital LOS, or disease duration (P = NS). Mortality was similar in non-HTG-NP (7.1%) and HTG-NP (7.7%), P = 1.0. CONCLUSION In this large, single-institution series, necrotizing pancreatitis caused by hypertriglyceridemia had similar disease severity, morbidity, and mortality as necrotizing pancreatitis caused by other etiologies.
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Affiliation(s)
- T K Maatman
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | | | - E P Ceppa
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | - M G House
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | - A Nakeeb
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | - T K Nguyen
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | - C M Schmidt
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA
| | - N J Zyromski
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive EH 519, Indianapolis, IN, 46202, USA.
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Nguyen TK, Chua D, Shannon NB, Ng JCF, Tan HK. The show must go on. Br J Surg 2020; 107:e201. [PMID: 32383160 PMCID: PMC7267535 DOI: 10.1002/bjs.11684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/13/2022]
Affiliation(s)
- T K Nguyen
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre, Singapore
| | - D Chua
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre, Singapore
| | - N B Shannon
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre, Singapore
| | - J C F Ng
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre, Singapore
| | - H K Tan
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre, Singapore
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Flick KF, Al-Temimi MH, Maatman TK, Sublette CM, Swensson JK, Nakeeb A, Ceppa EP, Nguyen TK, Schmidt CM, Zyromski NJ, Tann MA, House MG. Hepatic Steatosis After Neoadjuvant Chemotherapy for Pancreatic Cancer: Incidence and Implications for Outcomes After Pancreatoduodenectomy. J Gastrointest Surg 2020; 24:2008-2014. [PMID: 32671796 PMCID: PMC7363010 DOI: 10.1007/s11605-020-04723-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/28/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND This study aimed to determine the incidence of new onset hepatic steatosis after neoadjuvant chemotherapy for pancreatic cancer and its impact on outcomes after pancreatoduodenectomy. METHODS Retrospective review identified patients who received neoadjuvant chemotherapy for pancreatic adenocarcinoma and underwent pancreatoduodenectomy from 2013 to 2018. Preoperative computed tomography scans were evaluated for the development of hepatic steatosis after neoadjuvant chemotherapy. Hypoattenuation included liver attenuation greater than or equal to 10 Hounsfield units less than tissue density of spleen on noncontrast computed tomography and greater than or equal to 20 Hounsfield units less on contrast-enhanced computed tomography. RESULTS One hundred forty-nine patients received neoadjuvant chemotherapy for a median of 5 cycles (interquartile range (IQR), 4-6). FOLFIRINOX was the regimen in 78% of patients. Hepatic steatosis developed in 36 (24%) patients. The median time from neoadjuvant chemotherapy completion to pancreatoduodenectomy was 40 days (IQR, 29-51). Preoperative biliary stenting was performed in 126 (86%) patients. Neoadjuvant radiotherapy was delivered to 23 (15%) patients. Female gender, obesity, and prolonged exposure to chemotherapy were identified as risk factors for chemotherapy-associated hepatic steatosis. Compared with control patients without neoadjuvant chemotherapy-associated hepatic steatosis, patients developing steatosis had similar rates of postoperative pancreatic fistula (8% (control) vs. 4%, p = 0.3), delayed gastric emptying (8% vs. 14%, p = 0.4), and major morbidity (11% vs. 15%, p = 0.6). Ninety-day mortality was similar between groups (8% vs. 2%, p = 0.08). CONCLUSION Hepatic steatosis developed in 24% of patients who received neoadjuvant chemotherapy but was not associated with increased morbidity or mortality after pancreatoduodenectomy.
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Affiliation(s)
- K. F. Flick
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - M. H. Al-Temimi
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - T. K. Maatman
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - C. M. Sublette
- Indiana University School of Medicine, Indianapolis, IN USA
| | - J. K. Swensson
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN USA
| | - A. Nakeeb
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - E. P. Ceppa
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - T. K. Nguyen
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - C. M. Schmidt
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - N. J. Zyromski
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
| | - M. A. Tann
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN USA
| | - M. G. House
- Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN 46202 USA
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Luk AO, Li X, Zhang Y, Guo X, Jia W, Li W, Weng J, Yang W, Chan WB, Ozaki R, Tsang CC, Mukhopadhyay M, Ojha AK, Hong EG, Yoon KH, Sobrepena L, Toledo RM, Duran M, Sheu W, Q Do T, Nguyen TK, Ma RC, Kong AP, Chow CC, Tong PC, So WY, Chan JC. Quality of care in patients with diabetic kidney disease in Asia: The Joint Asia Diabetes Evaluation (JADE) Registry. Diabet Med 2016; 33:1230-9. [PMID: 26511783 DOI: 10.1111/dme.13014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 12/18/2022]
Abstract
AIMS Diabetic kidney disease independently predicts cardiovascular disease and premature death. We examined the burden of chronic kidney disease (CKD, defined as an estimated GFR < 60 ml/min/1.73 m(2) ) and quality of care in a cross-sectional survey of adults (age ≥ 18 years) with Type 2 diabetes across Asia. METHODS The Joint Asia Diabetes Evaluation programme is a disease-management programme implemented using an electronic portal that systematically captures clinical characteristics of all patients enrolled. Between July 2007 and December 2012, data on 28 110 consecutively enrolled patients (China: 3415, Hong Kong: 15 196, India: 3714, Korea: 1651, Philippines: 3364, Vietnam: 692, Taiwan: 78) were analysed. RESULTS In this survey, 15.9% of patients had CKD, 25.0% had microalbuminuria and 12.5% had macroalbuminuria. Patients with CKD were less likely to achieve HbA1c < 53 mmol/mol (7.0%) (36.0% vs. 42.3%) and blood pressure < 130/80 mmHg (20.8% vs. 35.3%), and were more likely to have retinopathy (26.2% vs. 8.7%), sensory neuropathy (29.0% vs. 7.7%), cardiovascular disease (26.6% vs. 8.7%) and self-reported hypoglycaemia (18.9% vs. 8.2%). Despite high frequencies of albuminuria (74.8%) and dyslipidaemia (93.0%) among CKD patients, only 49.0% were using renin-angiotensin system inhibitors and 53.6% were on statins. On logistic regression, old age, male gender, tobacco use, long disease duration, high HbA1c , blood pressure and BMI, and low LDL cholesterol were independently associated with CKD (all P < 0.05). CONCLUSIONS The poor control of risk factors, suboptimal use of organ-protective drugs and high frequencies of hypoglycaemia highlight major treatment gaps in patients with diabetic kidney disease in Asia.
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Affiliation(s)
- A O Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - X Li
- Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, China
| | - Y Zhang
- Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, China
| | - X Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - W Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - W Li
- Peking Union Medical College Hospital, Beijing, China
| | - J Weng
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong, Beijing, China
| | - W Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - W B Chan
- Qualigenics Diabetes Centre, Hong Kong SAR, China
| | - R Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C C Tsang
- Alice Ho Nethersole Hospital, Hong Kong SAR, China
| | | | | | - E G Hong
- Hallym University College of Medicine, Gangwon-do, Korea
| | - K H Yoon
- The Catholic University of Korea, Seocho-gu, Korea
| | - L Sobrepena
- Heart of Jesus Hospital, San Jose City, Philippines
| | - R M Toledo
- Senor Sto. Nino Hospital, Tarlac, Philippines
| | - M Duran
- New Bilibid Prison Hospital, Bureau of Corrections, Muntinlupa, Philippines
| | - W Sheu
- Taichung Veterans General Hospital, Taichung, Taiwan
| | - T Q Do
- Bach Mai Hospital, Hanoi, Vietnam
| | - T K Nguyen
- HCMC University of Pharmaceutical and Medicine, Ho Chi Minh City, Vietnam
| | - R C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A P Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C C Chow
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong SAR, China
| | - P C Tong
- Qualigenics Diabetes Centre, Hong Kong SAR, China
| | - W Y So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J C Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, China
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Tran TM, Komatsu T, Nguyen TK, Nguyen VC, Yoshimura Y, Takahashi K, Wariishi M, Sakai T, Yamamoto S. Blood pressure, serum cholesterol concentration and their related factors in urban and rural elderly of Ho Chi Minh City. J Nutr Sci Vitaminol (Tokyo) 2001; 47:147-55. [PMID: 11508706 DOI: 10.3177/jnsv.47.147] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In Vietnam, information about blood pressure, serum lipids and their factors is limited. To obtain some of this information, a cross sectional nutrition survey was carried out in an urban and rural area of Ho Chi Minh City with 217 participants aged 60-69 y (148 females and 69 males). Anthropometry and blood pressure were measured. For three consecutive weekdays, 24 h dietary recalls were performed. Single 24 h urine was collected for sodium and potassium analysis. A fasting blood sample was taken and biochemical parameters were measured. Results indicate a high percentage of hypertension in urban (female: 35.5%, male: 43.8%) and rural areas (female: 22.2%, male: 35.1%). Blood pressure was correlated with body mass index (BMI) and 24 h urinary sodium-to-potassium (Na/K) ratio. A high prevalence of serum total cholesterol (TC) above 220 mg/dL (female: 55.3%, male: 31.3%) and overweight (female: 34.2%, male: 25.0%) were observed in urban residents. By contrast, 5.6% and 24.3% of rural females and males respectively had TC below 150 mg/dL and both genders had the same prevalence of underweight (32.4%). TC was positively correlated with body weight, BMI, dietary protein and dietary lipids. Overweight might be a major risk factor for hypertension in our urban elderly. A high Na/K intake ratio might be a risk factor for hypertension in both areas. The high prevalence of elevated TC in the urban area might to be related to the high lipid intake, and the high prevalence of low TC in the rural area might to be related to the low lipid intake.
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Affiliation(s)
- T M Tran
- Department of Nutrition, School of Medicine, The University of Tokushima, Japan
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Abstract
We have evaluated the potential of urinary uronic acid measurement as an early indicator in the development of renal papillary necrosis (RPN). Urinary uronic acid was quantified with a range of other urinary biochemical parameters in rats given multiple doses of N-phenylanthranilic acid (NPAA) or mefenamic acid (MFA), each of which induces a dose-related papillary necrosis. In addition, histological examination was also carried out to confirm the development and presence of RPN. NPAA was administered to male wistar rats at p.o. doses of 100, 250, and 500 mg/kg and MFA at p.o. doses of 75, 150, and 300 mg/kg on days 1-4 and 8-11, and urine samples were collected for 16 hours each day. NPAA increased uronic acid excretion two-fold for both medium and high doses from day four. MFA increased uronic acid excretion to two and a half-fold by day 10 in the highest dose administered. Urinary creatinine was equally elevated in a dose-related manner following treatment with either NPAA or MFA. None of the other routine markers (urinary or serum) of nephrotoxicity showed any statistical changes. NPAA produced a dose- and time-related increase in excretion of uronic acid. Evidence of widespread papillary necrosis was seen histologically at the high doses of NPAA or MFA. The significant elevation of uronic acid in urine following treatment with either NPAA or MFA was well ahead of the development of RPN detectable by routine histology, suggesting that uronic acid measurement could serve as an early indicator of RPN. The assessment of urinary uronic acid may therefore provide a novel sensitive and selective marker of identifying the lesion earlier than is currently possible. An increase in urinary uronic acid following NPAA and MFA treatment supports the biochemical basis of these changes as a representative of acid mucopolysaccharides accumulation.
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Affiliation(s)
- T K Nguyen
- Pharmaceutical Sciences Research Institute, Aston University, Birmingham, UK.
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8
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Fiscella RG, Nguyen TK, Cwik MJ, Phillpotts BA, Friedlander SM, Alter DC, Shapiro MJ, Blair NP, Gieser JP. Aqueous and vitreous penetration of levofloxacin after oral administration. Ophthalmology 1999; 106:2286-90. [PMID: 10599658 DOI: 10.1016/s0161-6420(99)90527-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the penetration of levofloxacin, an optical S-(-)isomer of ofloxacin, into the aqueous and vitreous humor after oral administration. DESIGN Randomized, clinical trial comparing tissue levels of levofloxacin after one or two doses 12 hours apart. PARTICIPANTS Forty-five patients undergoing initial vitrectomy between February 1997 and June 1997 at the UIC Eye Center. METHODS Aqueous, vitreous, and serum samples were obtained and later analyzed from 45 patients after oral administration of 1 500-mg tablet (group 1, 22 patients) or 2 500-mg tablets (group 2, 23 patients) 12 hours apart before surgery. MAIN OUTCOME MEASURES Aqueous, vitreous, and serum concentrations of levofloxacin (micrograms/milliliter). RESULTS Group 1 achieved mean aqueous, vitreous, and serum levels of 0.59 +/- 0.48 microg/ml, 0.32 +/- 0.34 microg/ml, and 4.34 +/- 3.59 microg/ml, respectively. Group 2 achieved mean aqueous, vitreous, and serum levels of 1.90 +/- 0.97 microg/ml, 2.39 +/- 0.70 microg/ml, and 8.02 +/- 3.14 microg/ml. CONCLUSIONS Mean inhibitory aqueous and vitreous MIC90 levels were achieved against a majority of ocular pathogens, including Staphylococcus aureus and Staphylococcus epidermidis, Streptococcus pneumoniae (vitreous), Bacillus cereus (vitreous), Haemophilus influenzae, Moraxella catarrhalis, and most gram-negative aerobic organisms except Pseudomonas aeruginosa after two doses given 12 hours apart. Mean MIC90 levels were obtained in the vitreous for a majority of pathogens responsible for traumatic, postoperative, or bleb-related endophthalmitis.
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Affiliation(s)
- R G Fiscella
- Department of Pharmacy Practice, University of Illinois at Chicago, 60612, USA.
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9
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Nguyen TK, Gagnon JA, Légaré E. Residents' corner. Answer to case of the month #64. Cronkhite-Canada syndrome. Can Assoc Radiol J 1999; 50:349-51. [PMID: 10555512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Affiliation(s)
- T K Nguyen
- Centre hospitalier universitaire de Québec (CHUQ).
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10
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Rule MC, Mutcherson RJ, Foss AD, Nguyen TK, Myrie KA, King TR. Mouse male sterility and histoincompatibility (mshi) maps between the D10Mit51/168/212 cluster and D10Mit213. Mamm Genome 1999; 10:447-50. [PMID: 10337616 DOI: 10.1007/s003359901021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The recessive male sterility and histoincompatibility (mshi) mutation in the mouse generates pleiotropic effects on graft transplantation and male reproduction. Previous analysis of backcross mice typed for mshi either by testicular morphology or by allograft rejection has located each trait to a 20-cM region on proximal mouse Chr 10. Here we present the microsatellite polymorphism analysis of a new 276-member intraspecific backcross panel--including a set of 135 males typed for sterility and histoincompatibility--that places both features controlled by mshi within a 1.7-cM interval between markers D10Mit51/168/212 and D10Mit213. In addition, this analysis has allowed an explicit test of a two-gene model for the mshi locus and has provided a measurement of the penetrance of the mshi-generated histogenic phenotype in both male (88.4 +/- 3.9%) and female (91.0 +/- 3.5%) mutants. The fine-structure map presented should facilitate a chromosome walk across this region and, ultimately, the molecular identification of the gene or genes affected by this interesting mutation.
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Affiliation(s)
- M C Rule
- Central Connecticut State University, New Britain 06050, USA
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11
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Affiliation(s)
- A P Spicer
- Department of Biological Chemistry, University of California, School of Medicine, Davis 95616, USA
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12
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Abstract
Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) are well recognized as a major class of therapeutic agent that causes renal papillary necrosis (RPN). Over the last decade a broad spectrum of other therapeutic agents and many chemicals have also been reported that have the potential to cause this lesion in animals and man. There is consensus that RPN is the primary lesion that can progress to cortical degeneration; and it is only at this stage that the lesion is easily diagnosed. In the absence of sensitive and selective noninvasive biomarkers of RPN there is still no clear indication of which compound, under what circumstances, has the greatest potential to cause this lesion in man. Attempts to mimic RPN in rodents using analgesics and NSAIDs have not provided robust models of the lesion. Thus, much of the research has concentrated on those compounds that cause an acute or subacute RPN as the basis by which to study the pathogenesis of the lesion. Based on the mechanistic understanding gleaned from these model compounds it has been possible to transpose an understanding of the underlying processes to the analgesics and NSAIDs. The mechanism of RPN is still controversial. There are data that support microvascular changes and local ischemic injury as the underlying cause. Alternatively, several model papillotoxins, some analgesics, and NSAIDs target selectively for the medullary interstitial cells, which is the earliest reported aberration, after which there are a series of degenerative processes affecting other renal cell types. Many papillotoxins have the potential to undergo prostaglandin hydroperoxidase-mediated metabolic activation, specifically in the renal medullary interstitial cells. These reactive intermediates, in the presence of large quantities of polyunsaturated lipid droplets, result in localized and selective injury of the medullary interstitial cells. These highly differentiated cells do not repair, and it is generally accepted that continuing insult to these cells will result in their progressive erosion. The loss of these cells is thought to be central to the degenerative cascade that affects the cortex. There is still a need to understand better the primary mechanism and the secondary consequences of RPN so that the risk of chemical agents in use and novel molecules can be fully assessed.
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Affiliation(s)
- P H Bach
- BioMedical Research Centre, Division of Biomedical Sciences, Sheffield Hallam University, England, United Kingdom
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13
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Abstract
STUDY OBJECTIVES The objective of this study was to determine the impact of the timing of chest tube insertion on outcome for the treatment of empyema, using a new animal model of empyema. DESIGN A prospective, controlled randomized, blinded design was used. SETTING The study was conducted in an animal research laboratory. PATIENTS OR PARTICIPANTS Sixty-six 2- to 3-kg rabbits were used in this study. INTERVENTIONS After induction of empyema, the rabbits were divided into four groups. Fourteen rabbits had chest tubes placed at 24 h after empyema induction. Seventeen rabbits had chest tubes placed at 48 h and 14 rabbits had chest tubes placed at 72 h after empyema induction. Twenty-one rabbits served as control rabbits and had no chest tubes placed. MEASUREMENTS AND RESULTS Ten days after induction of empyema, the rabbits were killed. The pleural spaces of each rabbit were examined and a gross score, pleural peel score, and a microscopic score were calculated for each rabbit. The median gross score, mean pleural peel score, and median microscopic scores were significantly higher in the rabbits that underwent late chest tube placement (72 h) relative to those that underwent early chest tube placement (24 or 48 h). CONCLUSIONS This study supports previous expert opinion statements and conclusions from retrospective analyses that early chest tube placement (relative to delayed chest tube placement) is beneficial for the treatment of empyema.
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Affiliation(s)
- S Sasse
- Long Beach VAMC, Calif 90822, USA
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Abstract
Breath-holding serves as a model for studying gas exchange during clinical situations in which cessation of ventilation occurs. We chose to examine the arterial blood gas changes that occurred during breath-holding, when breath-holding was initiated from functional residual capacity (FRC) while breathing room air. Eight normal subjects who had a radial artery catheter placed for another study were taught to breath-hold on command from FRC. FRC was determined using respiratory inductance plethysmography. Arterial blood gas specimens were obtained at 5-s intervals until the termination of breath-holding. The average breath-holding time (+/-SD) was 35 (+/-10 s). The PaO2, PaCO2, and pH values were plotted against time and individually fit to logistic equations for each subject. The arterial PaO2 fell by a mean of 50 mm Hg during the first 35 s of breath-holding under these conditions, while the arterial PCO2 rose by a mean of 10.2 mm Hg during the first 35 s and the pH fell by a mean of 0.07 in the first 35 s. The rapid decline in PaO2 is greater than that previously reported using different methods and should be considered in clinical situations in which there is an interruption of oxygenation and ventilation at FRC while breathing room air. The changes in PaCO2 and pH are similar to those previously reported in paralyzed apneic patients.
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Affiliation(s)
- S A Sasse
- Department of Medicine, Long Beach (Calif) VA Medical Center 90822, USA
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Gornostaeva RM, Vu TF, Nguyen VC, Nguyen TK, Nguyen SZ, Nguyen TR, Nguyen TV. [The sensitivity of malarial mosquitoes in the fauna of the Socialist Republic of Vietnam to insecticides]. Med Parazitol (Mosk) 1994:34-41. [PMID: 7912409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Nguyen TK, Martínková L, Seichert L, Machek F. Citric acid production by Aspergillus niger using media containing low concentrations of glucose or corn starch. Folia Microbiol (Praha) 1992; 37:433-41. [PMID: 1296926 DOI: 10.1007/bf02899902] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
By using an appropriate ratio of carbon source to mineral components, we obtained comparable citrate yields in media containing different concentrations of glucose. The enzyme system of inoculum passed on gradually from "growth" state to "production" state during the mould growth. In the starch medium, the critical factors of citric acid production are the aeration efficiency of the medium and the amylase formation of the strain. The air interruption exhibited a prolonged inhibition of the production rate but not of the citrate yield in glucose medium while those parameters in starch medium containing excessive urea were briefly but severely inhibited. After being affected by these unfavorable conditions, the production activity of Aspergillus niger could be restored by applying an appropriate fermentation process.
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Affiliation(s)
- T K Nguyen
- Department of Biotechnology, Czechoslovak Academy of Sciences, Prague
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Pham VZ, Nguyen TK. [Comparative diagnostic effectiveness of different radionuclide methods in patients with nodular goiter]. Med Radiol (Mosk) 1984; 29:56-9. [PMID: 6748890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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18
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Nguyen TK, Smirnov VS, Mozzhakov VI. [30th anniversary of the Central Military Hospital of the Vietnam People's Army]. Voen Med Zh 1981:61-2. [PMID: 7032058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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