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[PMID]: 27085007
[Au] Autor:Chanová M; Hrdý J
[Ad] Address:Institute of Immunology and Microbiology of the First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.
[Ti] Title:Impact of Induced Th1/Th2 Shift on Trichobilharzia regenti Infection in Mice.
[So] Source:Folia Biol (Praha);62(1):26-33, 2016.
[Is] ISSN:0015-5500
[Cp] Country of publication:Czech Republic
[La] Language:eng
[Ab] Abstract:Bird schistosomes parasitize mammals as non-specific hosts. Neurotropic Trichobilharzia regenti migrates extravasally via nervous tissue in experimentally infected mice. The majority of successfully penetrated larvae remain in the skin; the rest migrate through peripheral nerves to the spinal cord and brain. The potential of schistosomula to leave the skin and enter the central nervous system vary, and may be associated with Th1/Th2 polarization of the host cell immune response. The aim of the present study was to evaluate the impact of induced shift in polarization of cell immune response on the migration of T. regenti larvae in mammals. For this purpose, non-specifically immunomodulated mice were infected. The localization and abundance of schistosomula and associated histopathological changes were followed using routine histological techniques. Markers characterizing Th1 and Th2 systemic immune responses were followed using flow cytometry. The study revealed that the shift towards Th1 response at the time of infection correlates with the speed and intensity of schistosomula migration towards the brain and with the severity of accompanying pathologies. This indicates increased health risks associated with T. regenti infection for mammals (potentially including human) with previously modulated cell immune response that may occur under natural conditions, e.g. due to the exposure to another infectious agent.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[St] Status:In-Data-Review

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[PMID]: 26603258
[Au] Autor:Munster P; Aggarwal R; Hong D; Schellens JH; van der Noll R; Specht J; Witteveen PO; Werner TL; Dees EC; Bergsland E; Agarwal N; Kleha JF; Durante M; Adams L; Smith DA; Lampkin TA; Morris SR; Kurzrock R
[Ad] Address:University of California, San Francisco, California. pmunster@medicine.ucsf.edu....
[Ti] Title:First-in-Human Phase I Study of GSK2126458, an Oral Pan-Class I Phosphatidylinositol-3-Kinase Inhibitor, in Patients with Advanced Solid Tumor Malignancies.
[So] Source:Clin Cancer Res;22(8):1932-9, 2016 Apr 15.
[Is] ISSN:1078-0432
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: GSK2126458 (GSK458) is a potent inhibitor of PI3K (α, ß, γ, and δ), with preclinical studies demonstrating broad antitumor activity. We performed a first-in-human phase I study in patients with advanced solid tumors. MATERIALS AND METHODS: Patients received oral GSK458 once or twice daily in a dose-escalation design to define the maximum tolerated dose (MTD). Expansion cohorts evaluated pharmacodynamics, pharmacokinetics, and clinical activity in histologically and molecularly defined cohorts. RESULTS: One hundred and seventy patients received doses ranging from 0.1 to 3 mg once or twice daily. Dose-limiting toxicities (grade 3 diarrhea,n= 4; fatigue and rash,n= 1) occurred in 5 patients (n= 3 at 3 mg/day). The MTD was 2.5 mg/day (MTD with twice daily dosing undefined). The most common grade ≥3 treatment-related adverse events included diarrhea (8%) and skin rash (5%). Pharmacokinetic analyses demonstrated increased duration of drug exposure above target level with twice daily dosing. Fasting insulin and glucose levels increased with dose and exposure of GSK458. Durable objective responses (ORs) were observed across multiple tumor types (sarcoma, kidney, breast, endometrial, oropharyngeal, and bladder cancer). Responses were not associated withPIK3CAmutations (OR rate: 5% wild-type vs. 6% mutant). CONCLUSIONS: Although the MTD of GSK458 was 2.5 mg once daily, twice-daily dosing may increase duration of target inhibition. Fasting insulin and glucose levels served as pharmacodynamic markers of drug exposure. Select patients achieved durable responses; however,PIK3CAmutations were neither necessary nor predictive of response. Combination treatment strategies and novel biomarkers may be needed to optimally target PI3K.Clin Cancer Res; 22(8); 1932-9. ©2015 AACR.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1158/1078-0432.CCR-15-1665

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[PMID]: 26204821
[Au] Autor:Weatherly LM; Shim J; Hashmi HN; Kennedy RH; Hess ST; Gosse JA
[Ad] Address:Graduate School of Biomedical Science and Engineering, Orono, ME, USA....
[Ti] Title:Antimicrobial agent triclosan is a proton ionophore uncoupler of mitochondria in living rat and human mast cells and in primary human keratinocytes.
[So] Source:J Appl Toxicol;36(6):777-89, 2016 Jun.
[Is] ISSN:1099-1263
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Triclosan (TCS) is an antimicrobial used widely in hospitals and personal care products, at ~10 mm. Human skin efficiently absorbs TCS. Mast cells are ubiquitous key players both in physiological processes and in disease, including asthma, cancer and autism. We previously showed that non-cytotoxic levels of TCS inhibit degranulation, the release of histamine and other mediators, from rat basophilic leukemia mast cells (RBL-2H3), and in this study, we replicate this finding in human mast cells (HMC-1.2). Our investigation into the molecular mechanisms underlying this effect led to the discovery that TCS disrupts adenosine triphosphate (ATP) production in RBL-2H3 cells in glucose-free, galactose-containing media (95% confidence interval EC50 = 7.5-9.7 µm), without causing cytotoxicity. Using these same glucose-free conditions, 15 µm TCS dampens RBL-2H3 degranulation by 40%. The same ATP disruption was found with human HMC-1.2 cells (EC50 4.2-13.7 µm), NIH-3 T3 mouse fibroblasts (EC50 4.8-7.4 µm) and primary human keratinocytes (EC50 3.0-4.1 µm) all with no cytotoxicity. TCS increases oxygen consumption rate in RBL-2H3 cells. Known mitochondrial uncouplers (e.g., carbonyl cyanide 3-chlorophenylhydrazone) previously were found to inhibit mast cell function. TCS-methyl, which has a methyl group in place of the TCS ionizable proton, affects neither degranulation nor ATP production at non-cytotoxic doses. Thus, the effects of TCS on mast cell function are due to its proton ionophore structure. In addition, 5 µm TCS inhibits thapsigargin-stimulated degranulation of RBL-2H3 cells: further evidence that TCS disrupts mast cell signaling. Our data indicate that TCS is a mitochondrial uncoupler, and TCS may affect numerous cell types and functions via this mechanism. Copyright © 2015 John Wiley & Sons, Ltd.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1002/jat.3209

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[PMID]: 27076754
[Au] Autor:Nocchi SR; de Moura-Costa GF; Novello CR; Rodrigues J; Longhini R; de Mello JC; Filho BP; Nakamura CV; Ueda-Nakamura T
[Ad] Address:Post-Graduate Program in Pharmaceutical Sciences, State University of Maringá, Maringá, Paraná, Brazil....
[Ti] Title:In vitro Cytotoxicity and Anti-herpes Simplex Virus Type 1 Activity of Hydroethanolic Extract, Fractions, and Isolated Compounds from Stem Bark of Schinus terebinthifolius Raddi.
[So] Source:Pharmacogn Mag;12(46):160-4, 2016 Apr-Jun.
[Is] ISSN:0973-1296
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND: Herpes simplex virus type 1 (HSV-1) is associated with orofacial infections and is transmitted by direct contact with infected secretions. Several efforts have been expended in the search for drugs to the treatment for herpes. Schinus terebinthifolius is used in several illnesses and among them, for the topical treatment of skin wounds, especially wounds of mucous membranes, whether infected or not. OBJECTIVE: To evaluate the cytotoxicity and anti-HSV-1 activity of the crude hydroethanolic extract (CHE) from the stem bark of S. terebinthifolius, as well as its fractions and isolated compounds. MATERIALS AND METHODS: The CHE was subjected to bioguided fractionation. The anti-HSV-1 activity and the cytotoxicity of the CHE, its fractions, and isolated compounds were evaluated in vitro by SRB method. A preliminar investigation of the action of CHE in the virus-host interaction was conducted by the same assay. RESULTS: CHE presented flavan-3-ols and showed anti-HSV-1 activity, better than its fractions and isolated compounds. The class of substances found in CHE can bind to proteins to form unstable complexes and enveloped viruses, as HSV-1 may be vulnerable to this action. Our results suggest that the CHE interfered with virion envelope structures, masking viral receptors that are necessary for adsorption or entry into host cells. CONCLUSION: The plant investigated exhibited potential for future development treatment against HSV-1, but further tests are necessary, especially to elucidate the mechanism of action of CHE, as well as preclinical and clinical studies to confirm its safety and efficacy. SUMMARY: Crude hydroethanolic extract (CHE) presents promising activity against herpes simplex virus type 1 (HSV 1), with selectivity index (SI) = 22.50CHE has flavan-3-ols in its composition, such as catechin and gallocatechinThe fractions and isolated compounds obtained from CHE by bioguided fractionation are less active than the CHE against HSV-1CHE interferes with viral entry process in the host cell and acts directly on the viral particle. Abbreviations used: HSV: Herpes simplex virus, CHE: Crude hydroethanolic extract, WF: Water fraction, AF: Ethyl-acetate fraction, MPLC: Medium-performance liquid chromatography, TLC: Thin-layer chromatography, NMR: Nuclear magnetic resonance, ESI-MS: Electrospray ionization mass spectrometry, SRB: Sulforhodamine B, CPE: Cytopathic effect, CC50: 50% cytotoxic concentration, EC50: 50% effective concentration, PBS: Phosphate-buffered saline.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Da] Date of entry for processing:160414
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/0973-1296.177903

  5 / 639433 MEDLINE  
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[PMID]: 26934294
[Au] Autor:Klassen AF; Cano SJ; Schwitzer JA; Baker SB; Carruthers A; Carruthers J; Chapas A; Pusic AL
[Ad] Address:Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada....
[Ti] Title:Development and Psychometric Validation of the FACE-Q Skin, Lips, and Facial Rhytids Appearance Scales and Adverse Effects Checklists for Cosmetic Procedures.
[So] Source:JAMA Dermatol;152(4):443-51, 2016 Apr 1.
[Is] ISSN:2168-6084
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:IMPORTANCE: Patient-reported outcomes data are needed to determine the efficacy of cosmetic procedures. OBJECTIVE: To describe the development and psychometric evaluation of 8 appearance scales and 2 adverse effect checklists for use in minimally invasive cosmetic procedures. DESIGN, SETTING, AND PARTICIPANTS: We performed a psychometric study to select the most clinically sensitive items for inclusion in item-reduced scales and to examine reliability and validity with patients. Recruitment of the sample for this study took place from June 6, 2010, through July 28, 2014. Data analysis was performed from December 11, 2014, to December 22, 2015. Pretreatment and posttreatment patients 18 years and older who were consulting for any type of facial aesthetic treatment were studied. Patients were from plastic surgery and dermatology outpatient clinics in the United States and Canada (field-test sample) and a clinical trial of a minimally invasive lip treatment in the United Kingdom and France (clinical trial sample). MAIN OUTCOMES AND MEASURES: The FACE-Q scales that measure appearance of the skin, lips, and facial rhytids (ie, overall, forehead, glabella, lateral periorbital area, lips, and marionette lines), with scores ranging from 0 (lowest) to 100 (highest), and the FACE-Q adverse effects checklists for problems after skin and lip treatment. RESULTS: Of 783 patients recruited, 503 field-test patients (response rate, 90%) and 280 clinical trial participants were studied. The mean (SD) age of the patients was 47.4 (14.0) years in the field-test sample and 47.7 (12.3) years in the clinical trial sample. Most of the patients were female (429 [85.3%] in the field-test sample and 274 [97.9%] in the clinical trial sample). Rasch Measurement Theory analyses led to the refinement of 8 appearance scales with 66 total items. All FACE-Q scale items had ordered thresholds and acceptable item fit. Reliability, measured with the Personal Separation Index (range, 0.88-0.95) and Cronbach α (range, 0.93-0.98), was high. Lower scores for appearance scales that measured the skin (r = -0.48, P < .001), lips (r = -0.21, P = .001), and lip rhytids (r = -0.32, P < .001) correlated with the reporting of more skin- and lip-related adverse effects. Higher scores for the 8 appearance scales correlated (range, 0.70-0.28; P < .001) with higher scores on the core 10-item FACE-Q satisfaction with facial appearance scale. In the pretreatment group, older age was significantly correlated with lower scores on 5 of the 6 rhytids scales (exception was forehead rhytids) (range, -0.28 to -0.65; P = .03 to <.001). Pretreatment patients reported significantly lower scores on 7 of the 8 appearance scales compared with posttreatment patients (exception was skin) (P < .001 to .005 on independent sample t tests). CONCLUSIONS AND RELEVANCE: The FACE-Q appearance scales and adverse effects checklists can be used in clinical practice, research, and quality improvement to incorporate cosmetic patients' perspective in outcome assessments.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1001/jamadermatol.2016.0018

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[PMID]: 26765315
[Au] Autor:Ally MS; Ransohoff K; Sarin K; Atwood SX; Rezaee M; Bailey-Healy I; Kim J; Beachy PA; Chang AL; Oro A; Tang JY; Colevas AD
[Ad] Address:Department of Dermatology, Stanford University, Stanford, California....
[Ti] Title:Effects of Combined Treatment With Arsenic Trioxide and Itraconazole in Patients With Refractory Metastatic Basal Cell Carcinoma.
[So] Source:JAMA Dermatol;152(4):452-6, 2016 Apr 1.
[Is] ISSN:2168-6084
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:IMPORTANCE: Tumor resistance is an emerging problem for Smoothened (SMO) inhibitor-treated metastatic basal cell carcinoma (BCC). Arsenic trioxide and itraconazole antagonize the hedgehog (HH) pathway at sites distinct from those treated by SMO inhibitors. OBJECTIVE: To determine whether administration of intravenous arsenic trioxide and oral itraconazole in patients with metastatic BCC is associated with a reduction in GLI1 messenger RNA expression in tumor and/or normal skin biopsy samples. DESIGN, SETTING, AND PARTICIPANTS: Five men with metastatic BCC who experienced relapse after SMO inhibitor treatment underwent intravenous arsenic trioxide treatment for 5 days, every 28 days, and oral itraconazole treatment on days 6 to 28. Data were collected from April 10 to November 14, 2013. Follow-up was completed on October 3, 2015, and data were analyzed from June 5 to October 6, 2015. MAIN OUTCOMES AND MEASURES: The primary outcome was the change in messenger RNA levels of the GLI family zinc finger 1 (GLI1) gene (HH-pathway target gene) in biopsy specimens of normal skin or BCC before and after treatment. Secondary objectives were evaluation of tumor response and tolerability. RESULTS: Of the 5 patients (mean [SD] age, 52 [9] years; age range, 43-62 years), 3 completed 3 cycles of treatment and 2 discontinued treatment early owing to disease progression or adverse events. Adverse effects included grade 2 transaminitis and grade 4 leukopenia with a grade 3 infection. Overall, arsenic trioxide and itraconazole reduced GLI1 messenger RNA levels by 75% from baseline (P < .001). The best overall response after 3 treatment cycles was stable disease in 3 patients. CONCLUSIONS AND RELEVANCE: Targeting the HH pathway with sequential arsenic trioxide and itraconazole treatment is a feasible treatment for metastatic BCC. Although some patients experienced stable disease for 3 months, none had tumor shrinkage, which may be owing to transient GLI1 suppression with sequential dosing. Continuous dosing may be required to fully inhibit the HH pathway and achieve clinical response.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1001/jamadermatol.2015.5473

  7 / 639433 MEDLINE  
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[PMID]: 27075584
[Au] Autor:Tel J; Koornstra R; de Haas N; van Deutekom V; Westdorp H; Boudewijns S; van Erp N; Di Blasio S; Gerritsen W; Figdor CG; de Vries IJ; Hato SV
[Ad] Address:Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands....
[Ti] Title:Preclinical exploration of combining plasmacytoid and myeloid dendritic cell vaccination with BRAF inhibition.
[So] Source:J Transl Med;14(1):88, 2016.
[Is] ISSN:1479-5876
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Melanoma is the most lethal type of skin cancer and its incidence is progressively increasing. The introductions of immunotherapy and targeted therapies have tremendously improved the treatment of melanoma. Selective inhibition of BRAF by vemurafenib results in objective clinical responses in around 50 % of patients suffering from BRAFV600 mutated melanoma. However, drug resistance often results in hampering long-term tumor control. Alternatively, immunotherapy by vaccination with natural dendritic cells (nDCs) demonstrated long-term tumor control in a proportion of patients. We postulate that the rapid tumor debulking by vemurafenib can synergize the long-term tumor control of nDC vaccination to result in an effective treatment modality in a large proportion of patients. Here, we investigated the feasibility of this combination by analyzing the effect of vemurafenib on the functionality of nDCs. METHODS: Plasmacytoid DCs (pDCs) and myeloid DCs (mDCs) were isolated from PBMCs obtained from buffy coats from healthy volunteers or vemurafenib-treated melanoma patients. Maturation of pDCs, mDCs and immature monocyte-derived DCs was induced by R848 in the presence or absence of vemurafenib and analyzed by FACS. Cytokine production and T cell proliferation induced by mature DCs were analyzed. RESULTS: Vemurafenib inhibited maturation and cytokine production of highly purified nDCs of healthy volunteers resulting in diminished allogeneic T cell proliferation. This deleterious effect of vemurafenib on nDC functionality was absent when total PBMCs were exposed to vemurafenib. In patients receiving vemurafenib, nDC functionality and T cell allostimulatory capacity were unaffected. CONCLUSION: Although vemurafenib inhibited the functionality of purified nDC of healthy volunteers, this effect was not observed when nDCs were matured in the complete PBMC fraction. This might have been caused by increased vemurafenib uptake in absence of other cell types. In accordance, nDCs isolated from patients on active vemurafenib treatment showed no negative effects. In conclusion, our results pave the way for a combinatorial treatment strategy and, we propose that combining vemurafenib with nDC vaccination represent a powerful opportunity that deserves more investigation in the clinic.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s12967-016-0844-6

  8 / 639433 MEDLINE  
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[PMID]: 27076885
[Au] Autor:Yazdanirad S; Dehghan H
[Ad] Address:Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
[Ti] Title:Designing of the Cooling Vest from Paraffin Compounds and Evaluation of its Impact Under Laboratory Hot Conditions.
[So] Source:Int J Prev Med;7:47, 2016.
[Is] ISSN:2008-7802
[Cp] Country of publication:Iran
[La] Language:eng
[Ab] Abstract:BACKGROUND: The phase change materials (PCMs) have the appropriate properties for controlling heat strain. One of the well-known PCMs is paraffin. This study aimed to design the cooling vest from the cheap commercial paraffin compound and evaluation of its effectiveness under laboratory hot conditions. METHODS: the cooling vest was made of the polyester fabric and it had 17 aluminum packs. The each of aluminum packs was filled by 135 g of prepared paraffin with a proper melting point in the range of 15-35°C. an experimental study was conducted on ten male students under warm conditions (air temperature = 40°C, relative humidity = 40%) in a climatic chamber. Each participant was tested without cooling vest and with cooling in two activities rate on treadmill to include: light (2.8 km/h) and moderate (4.8 km/h). The time of this test was 30 min in each stage. During the test, the heart rate, the oral temperature, the skin temperature were measured every 4 min. Finally, data were analyzed using the Kolmogrov-Smirnov and repeated measurement ANOVA test in SPSS 16. RESULTS: The latent heat of the prepared paraffin compound and the peak of the melting point were 108 kJ/kg and 30°C, respectively. The mean and standard deviation of heart rate, oral temperature, and skin temperature with cooling vest in light activity were 103.9 (12.12) beat/min, 36.77 (0.32)°C, and 31.01 (1.96)°C and in moderate activity were 109.5 (12.57) beat/min, 36.79 (0.20)°C, and 29.69 (2.23)°C, respectively. There is a significant difference between parameters with a cooling vest and without cooling (P < 0.05). CONCLUSIONS: The designed cooling vest with low cost can be used to prevent thermal strain and to increase the physiological stability against the heat. However, the latent heat of this cooling vest was low.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Da] Date of entry for processing:160414
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/2008-7802.177890

  9 / 639433 MEDLINE  
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[PMID]: 27076783
[Au] Autor:Ito Y; Inagaki Y; Kobuchi S; Takada K; Sakaeda T
[Ad] Address:1. Department of Pharmacokinetics, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto, 607-8412, Japan....
[Ti] Title:Therapeutic Drug Monitoring of Vancomycin in Dermal Interstitial Fluid Using Dissolving Microneedles.
[So] Source:Int J Med Sci;13(4):271-6, 2016.
[Is] ISSN:1449-1907
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To design an alternative painless method for vancomycin (VCM) monitoring by withdrawing interstitial fluid (ISF) the skin using dissolving microneedles (DMNs) and possibly replace the conventional clinical blood sampling method. METHODS: Male Wistar rats were anesthetized with 50 mg/kg sodium pentobarbital. Vancomycin at 5 mg/mL in saline was intravenously administered via the jugular vein. ISF was collected from a formed pore at 15, 30, 45, 60, 75, 90, and 120 min after the DMNs was removed from the skin. In addition, 0.3 mL blood samples were collected from the left femoral vein. RESULTS: The correlation between the plasma and ISF VCM concentrations was significantly strong (r = 0.676, p < 0.05). Microscopic observation of the skin after application of the DMNs demonstrated their safety as a device for sampling ISF. CONCLUSION: A novel monitoring method for VCM was developed to painlessly determine concentrations in the ISF as opposed to blood sampling.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.7150/ijms.13601

  10 / 639433 MEDLINE  
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[PMID]: 27076712
[Au] Autor:Harde M; Bhadade R; Iyer H; Jatale A; Tiwatne S
[Ad] Address:Department of Anaesthesiology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Maharashtra, India....
[Ti] Title:A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital.
[So] Source:Indian J Crit Care Med;20(2):109-13, 2016 Feb.
[Is] ISSN:0972-5229
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h) postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24), of them 7% (14) were from PACU and 5% (10) were from ward (P = 0.5285). Positive skin swab culture was 38% (150), of them 20% (80) were from PACU and 18% (70) were from ward (P = 0.3526). The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053-0.2289). The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160416
[Lr] Last revision date:160416
[Da] Date of entry for processing:160414
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/0972-5229.175943


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