Evaluation of cefepime alone and in combination with vancomycin against penicillin-resistant pneumococci in the rabbit meningitis model and in vitro

Cefepime, a broad-spectrum, fourth-generation cephalosporin, showed excellent CSF penetration with levels ranging between 10 and 16 mg/L after two intravenous injections (100 mg/kg). The bactericidal activity of cefepime (-0.60 +/- 0.28 Deltalog(10) cfu/mL/h) was superior to that of ceftriaxone (-0.34 +/- 0.23 Deltalog(10) cfu/mL/h, P < 0.05) and vancomycin (-0.39 +/- 0.19 Deltalog(10) cfu/mL/h, P < 0.05) in the treatment of rabbits with meningitis caused by an isolate highly resistant to penicillin (MIC of penicillin G: 4 mg/L). The addition of vancomycin to both cephalosporins did not significantly increase the killing rate compared with monotherapies (P > 0.05). Similar results were obtained in time-killing experiments in vitro.

Communality sells: The impact of perceivers' sexism on the evaluation of women's portrayals in advertisements

Portrayals of women in advertisements have a significant impact on the maintenance of gender stereotypes in society. Therefore, the present research investigates the effectiveness of communal and agentic female characters in advertisements as well as the question how evaluations of such characters are influenced by perceivers' sexist attitudes toward women. Results show that communal female advertising characters are evaluated more favorably than agentic ones and that these evaluations predict advertising effectiveness. Benevolent sexism predicts more positive evaluations of communal female advertising characters (studies 1 and 2). Moreover, hostile sexism predicts less positive evaluations of agentic female advertising characters when it is assessed under time pressure (Study 2). Implications of these findings for the perpetuation of gender stereotypes in advertisements and in society are discussed.

Swiss national guideline for reimbursement of enzyme replacement therapy in late-onset Pompe disease.

Glycogen storage disease type II is a rare multi-systemic disorder characterised by an intracellular accumulation of glycogen due a mutation in the acid alpha glucosidase (GAA) gene. The level of residual enzyme activity, the genotype and other yet unknown factors account for the broad variation of the clinical phenotype. The classical infantile form is characterised by severe muscle hypotonia and cardiomyopathy leading to early death. The late-onset form presents as a limb girdle myopathy with or without pulmonary dysfunction. Enzyme replacement therapy (ERT) with recombinant human GAA (rhGAA) in infants is life saving. In contrast, therapeutic efficacy of rhGAA in the late-onset form is modest. High expenses of rhGAA, on-going infusions and poor pharmacokinetic efficacy raised a discussion of the cost effectiveness of ERT in late-onset Pompe disease in Switzerland. This discussion was triggered by a Swiss federal court ruling which confirmed the reluctance of a health care insurer not to reimburse treatment costs in a 67-year-old female suffering from Pompe disease. As a consequence of this judgement ERT was stopped by all insurance companies in late-onset Pompe patients in Switzerland regardless of their clinical condition. Subsequent negotiations lead to the release of a national guideline of the management of late-onset Pompe disease. Initiation and limitation of ERT is outlined in a national Pompe registry. Reimbursement criteria are defined and individual efficacy of ERT with rhGAA is continuously monitored.

Patterns of Religious Education Policy in Switzerland. The Long Arm of Distanced Christians?

In spite of its different cantonal jurisdictions and traditions, the development of religious education in Switzerland over the past decade has taken a common direction: the state has assumed a more active role in the field of religious education in public (state-run) schools. In this article, we ask the question: How do key social actors interpret these reforms and how do these interpretations relate to the social structure of religion in Switzerland, in particular with respect to the majority category of the so-called distanced Christians? Drawing on qualitative interviews with members of the schools’ teaching staff, school administrators, and church representatives, the article highlights a dominant interpretative pattern that frames the socially accepted representation of religion in public schools. Thus, rather than addressing the pedagogical dimension of religious education, we discuss the significance of this pattern for the debate on the public presence of religion in Switzerland and Europe.

Soft perches in an aviary system reduce incidence of keel bone damage in laying hens.

Keel bone fractures and deviations are one of the major welfare and health issues in commercial laying hens. In non-cage housing systems like aviaries, falls and collisions with perches and other parts of the housing system are assumed to be one of the main causes for the high incidence of keel bone damage. The objectives of this study were to investigate the effectiveness of a soft perch material to reduce keel bone fractures and deviations in white (Dekalb White) and brown laying hens (ISA Brown) kept in an aviary system under commercial conditions. In half of 20 pens, all hard, metal perches were covered with a soft polyurethane material. Palpation of 20 hens per pen was conducted at 18, 21, 23, 30, 38, 44 and 64 weeks of age. Production data including egg laying rate, floor eggs, mortality and feed consumption were collected over the whole laying period. Feather condition and body mass was assessed twice per laying period. The results revealed that pens with soft perches had a reduced number of keel bone fractures and deviations. Also, an interaction between hybrid and age indicated that the ISA hybrid had more fractured keel bones and fewer non-damaged keel bones compared with the DW hybrid at 18 weeks of age, a response that was reversed at the end of the experiment. This is the first study providing evidence for the effectiveness of a soft perch material within a commercial setting. Due to its compressible material soft perches are likely to absorb kinetic energy occurring during collisions and increase the spread of pressure on the keel bone during perching, providing a mechanism to reduce keel bone fractures and deviations, respectively. In combination with genetic selection for more resilient bones and new housing design, perch material is a promising tool to reduce keel bone damage in commercial systems.

Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy

Coronary late stent thrombosis, a rare but devastating complication, remains an important concern in particular with the increasing use of drug-eluting stents. Notably, pathological studies have indicated that the proportion of uncovered coronary stent struts represents the best morphometric predictor of late stent thrombosis. Intracoronary optical frequency domain imaging (OFDI), a novel second-generation optical coherence tomography (OCT)-derived imaging method, may allow rapid imaging for the detection of coronary stent strut coverage with a markedly higher precision when compared with intravascular ultrasound, due to a microscopic resolution (axial approximately 10-20 microm), and at a substantially increased speed of image acquisition when compared with first-generation time-domain OCT. However, a histological validation of coronary OFDI for the evaluation of stent strut coverage in vivo is urgently needed. Hence, the present study was designed to evaluate the capacity of coronary OFDI by electron (SEM) and light microscopy (LM) analysis to detect and evaluate stent strut coverage in a porcine model.

Transjugular intravascular ultrasound for the evaluation of hepatic vasculature and parenchyma in patients with chronic liver disease

Background The evaluation of the hepatic parenchyma in patients with chronic liver disease is important to assess the extension, localization and relationship with adjacent anatomical structures of possible lesions. This is usually performed with conventional abdominal ultrasound, CT-scan or magnetic resonance imaging. In this context, the feasibility and the safety of intravascular ultrasound in the liver have not been assessed yet. Methods We tested the safety and performance of an intracardiac echography (ICE) catheter applied by a transjugular approach into the hepatic veins in patients with chronic liver disease undergoing hepatic hemodynamic measurements. Results Five patients were enrolled in this pilot study. The insertion of the ICE catheter was possible into the right and middle, but not into the left hepatic vein. The position of the ICE was followed using fluoroscopy and external conventional ultrasound. Accurate imaging of focal hepatic parenchymal lesions, Doppler ultrasound of surrounding blood vessels and assessment of liver surface and ascites were achieved without complications. Conclusions This study demonstrated that a diagnostic approach using an ICE device inserted in the hepatic veins is feasible, safe and well tolerated. However, it remains for the moment only an experimental investigative tool. Whether ICE adds further information regarding parenchymal lesions and associated vascular alterations as compared to other techniques, needs additional investigation.

Angioscopy for experimental evaluation of optional IVC filters

PURPOSE: To demonstrate the feasibility of direct angioscopic visualization of an optional inferior vena cava (IVC) filter in situ and during retrieval. MATERIALS AND METHODS: Angioscopy was used for direct visualization of optional IVC filters in six sheep. Cavograms were obtained before the filters were retrieved. After successful filter retrieval, segmental IVC perfusion was performed to evaluate filter retrieval-related damage to the IVC wall. Therefore, all branch vessels were ligated before the IVC segment was flushed with normal saline solution until it was fully distended. Then, the inflow was terminated and the IVC segment observed for deflation. Subsequently, the IVC was harvested en bloc, dissected, and inspected macroscopically. RESULTS: The visibility of IVC filters at angioscopy was excellent. During the retrieval procedure, filter collapse and retraction into the sheath were clearly demonstrated. Angioscopy provided additional information to that obtained with cavography, demonstrating adherent material in three filters. Three filters in place for more than 2 months could not be retrieved because the filter legs were incorporated into the IVC wall. After filter retrieval, there was no perforation at segmental IVC perfusion. At macroscopic inspection of the IVC lumen, a small piece of detached endothelium was found in one animal. CONCLUSION: Angioscopy enabled the direct evaluation of optional IVC filters in situ and during retrieval. Compared with cavography, angioscopy provided additional information about the filter in situ and the retrieval procedure. Future applications of this technique could include studies of filter migration, compression, and clot-trapping efficacy.