Intravenous streptomycin dosing regimen in a patient undergoing hemodialysis: Plasma level monitoring and pharmacokinetic simulation

Introduction: Streptomycin, as other aminoglycosides, exhibits concentration-dependent bacterial killing but has a narrow therapeutic window. It is primarily eliminated unchanged by the kidneys. Data and dosing information to achieve a safe regimen in patients with chronic renal failure undergoing hemodialysis (HD) are scarce. Although main adverse reactions are related to prolonged, elevated serum concentrations, literature recommendation is to administer streptomycin after each HD. Patients (or Materials) and Methods: We report the case of a patient with end-stage renal failure, undergoing HD, who was successfully treated with streptomycin for gentamicin-resistant Enterococcus faecalis bacteremia with prosthetic arteriovenous fistula infection. Streptomycin was administered intravenously 7.5 mg/kg, 3 hours before each dialysis (3 times a week) during 6 weeks in combination with amoxicillin. Streptomycin plasma levels were monitored with repeated blood sampling before, after, and between HD sessions. A 2-compartment model was used to reconstruct the concentration time profile over days on and off HD. Results: Streptomycin trough plasma-concentration was 2.8 mg/L. It peaked to 21.4 mg/L 30 minutes after intravenous administration, decreased to 18.2 mg/L immediately before HD, and dropped to 4.5 mg/L at the end of a 4-hour HD session. Plasma level increased again to 5.7 mg/L 2 hours after the end of HD and was 2.8 mg/L 48 hours later, before the next administration and HD. The pharmacokinetics of streptomycin was best described with a 2-compartment model. The computer simulation fitted fairly well to the observed concentrations during or between HD sessions. Redistribution between the 2 compartments after the end of HD reproduced the rebound of plasma concentrations after HD. No significant toxicity was observed during treatment. The outcome of the infection was favorable, and no sign of relapse was observed after a follow-up of 3 months. Conclusion: Streptomycin administration of 7.5 mg/kg 3 hours before HD sessions in a patient with end-stage renal failure resulted in an effective and safe dosing regimen. Monitoring plasma levels along with pharmacokinetic simulation document the suitability of this dosing scheme, which should replace current dosage recommendations for streptomycin in HD.

Revision of Central American species of Euryomma Stein (Diptera, Fanniidae), with description of two new species and updates of distributional records

Euryomma is the second largest genus within Fanniidae, but only two species, E. panamensis Chillcott, 1958 and E. rettenmeyeri Chillcott, 1958 have been recorded in Central America. In this paper we describe two new species of the genus found in Costa Rica, Euryomma chillcotti sp. nov. (Province of Puntarenas) and Euryomma steini sp. nov. (Provinces of Cartago and Limón). Euryomma tahami Grisales, Wolff & Carvalho, 2012 is recorded for the first time to Costa Rica. Identification key to all species found in Central America, descriptions and re-descriptions of species occurring in the region and illustrations of the terminalia of new species are presented.

Root system distribution of sugar cane as related to nitrogen fertilization, evaluated by two methods: monolith and probes

Few studies on sugar cane have evaluated the root system of the crop, in spite of its importance. This is mainly due to the difficulty of evaluation and high variability of results. The objective of this study was to develop an evaluation method of the cane root system by means of probes so as to evaluate the mass, distribution and metabolically active roots related to N fertilization at planting. For this purpose, an experiment was conducted in an Arenic Kandiustults with medium texture in Jaboticabal/SP, in a randomized block design with four replications and four treatments: control (without N) and 40, 80 and 120 kg ha-1 of N applied in the form of urea in the planting furrow of the cane variety SP81 3250. One week before harvest, a urea-15N solution was applied at the cane stalk base to detect active metabolism in the root system. Trenches of 1.5 m length and 0.6 m depth were opened between two sugar cane rows for root sampling by two methods: monoliths (0.3, 0.2 and 0.15 m wide, deep and long respectively) taken from the trench wall and by probe (internal diameter 0.055 m). For each method, 15 samples per plot were collected. The roots were separated from the soil in a sieve (2 mm mesh), oven-dried (at 65 ºC) and the dry matter was measured. Root sampling by probes resulted in root mass that did not differ from the evaluation in monoliths, indicating that this evaluation method may be used for sugar cane root mass, although neither the root distribution in the soil profile nor the rhizome mass were efficiently evaluated, due to the small sample volume. Nitrogen fertilization at planting did not result in a greater root accumulation in the sugar cane plant, but caused changes in the distribution of the root system in the soil. The absence of N fertilization led to a better root distribution in the soil profile, with 50, 34 and 16 % in the 0-0.2, 0.2-0.4 and 0.4-0.6 m layers, respectively; in the fertilized treatments the roots were concentrated in the surface layer, with on average 70, 17 and 13 % for the same layers. The metabolically active roots were concentrated in the center of the cane stool, amounting to 40 % of the total root mass, regardless of N fertilization (application of 120 kg ha-1 N or without N).

Two-stage prograde and retrograde Variscan metamorphism of glaucophane-eclogites, blueschists and greenschists from Ile de Groix (Brittany, France)

On Ile de Groix, Variscan metamorphic former tholeiitic and alkaline basalts occur as glaucophane-eclogites, blueschists and greenschists in isolated lenses and layers within metapelites. Whole-rock delta O-18(SMOW) values of the metabasites show limited variations (10.4-12.0 parts per thousand) and no systematic differences among rock types and metamorphic grades. This provides no argument for large-scale blueschist-to-greenschist transformation driven by infiltration of externally derived fluids. Metamorphic mineralogical changes should have been triggered by internal fluids. Element variations in interlayered blue- and greenschists can be attributed to magmatic fractionation. Assemblages with garnet, clinopyroxene and glaucophane of a high-pressure/low-temperature (HP-LT) metamorphism M1, and NaCa-amphiboles (barroisite, magnesiohornblende, actinolite) of a medium-pressure/medium-temperature metamorphism M2 crystallized during deformation Dl. Detailed core-rim zonation profiles display increasing and then decreasing Al-IV in glaucophane of M1. NaCa-amphiboles of M2, mantling glaucophane and crystallized in porphyroblasts, show first increasing, then decreasing, Al-IV and Al-IV. Empirically calibrated thermobarometers allowed P-T path reconstructions. In glaucophane-eclogites of a metamorphic zone I, a prograde evolution to M1 peak conditions at 400-500 degreesC/10-12 kbar was followed by a retrograde P-T path within the glaucophane stability field. The subsequent M2 evolution was again prograde up to > 600 degreesC at 8 kbar and then retrograde. Similarly, in metamorphic zones II and III, prograde and retrograde paths of MI and M2 at lower maximal temperatures and pressures exist. The almost complete metamorphic cycle during M2 signalizes that the HP-LT rocks escaped from an early erosion by a moderate second burial event and explains the longlasting slow uplift with low average cooling rates.

Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.

BACKGROUND: Polyomavirus-associated nephropathy (PVAN) is a serious complication and cause of graft loss in kidney transplant recipients. In the absence of specific antiviral drugs, early detection of the disease and reduction of immunosuppressive regimen is the cornerstone of therapy. Cidofovir, a nucleoside analogue, has been found to inhibit BK virus (BKV) replication in vitro and has been proposed as treatment of refractory PVAN at low doses; however, its efficacy has never been demonstrated in randomized controlled trials. METHODS: Cidofovir therapy (0.5 mg/kg at a 2-week interval for eight consecutive doses) was initiated in two patients with biopsy-proven PVAN and persistent BKV DNA viraemia (> or = 10,000 copies/ml despite sustained reduction of the immunosuppressive regimen). In addition to these two case reports, we performed a critical review of the literature on the use of cidofovir in PVAN. RESULTS: No significant decrease of BKV viral load in blood was observed during cidofovir therapy and in follow-up of the two patients treated with cidofovir. Our literature review identified 21 publications reporting the use of cidofovir for the treatment of PVAN. All were case reports or small series. The efficacy of cidofovir therapy could not be assessed in 17 of these publications because of lack of data or concomitant reduction of immunosuppressive regimen. The four remaining publications were case reports. CONCLUSIONS: In vitro and clinical data to support the efficacy of cidofovir in the treatment of PVAN are currently lacking. More promising compounds should be identified for further clinical studies.

Evaluation of sample preparation methods and optimization of nickel determination in vegetable tissues

Nickel, although essential to plants, may be toxic to plants and animals. It is mainly assimilated by food ingestion. However, information about the average levels of elements (including Ni) in edible vegetables from different regions is still scarce in Brazil. The objectives of this study were to: (a) evaluate and optimize a method for preparation of vegetable tissue samples for Ni determination; (b) optimize the analytical procedures for determination by Flame Atomic Absorption Spectrometry (FAAS) and by Electrothermal Atomic Absorption (ETAAS) in vegetable samples and (c) determine the Ni concentration in vegetables consumed in the cities of Lorena and Taubaté in the Vale do Paraíba, State of São Paulo, Brazil. By means of the analytical technique for determination by ETAAS or FAAS, the results were validated by the test of analyte addition and recovery. The most viable method tested for quantification of this element was HClO4-HNO3 wet digestion. All samples but carrot tissue collected in Lorena contained Ni levels above the permitted by the Brazilian Ministry of Health. The most disturbing results, requiring more detailed studies, were the Ni concentrations measured in carrot samples from Taubaté, where levels were five times higher than permitted by Brazilian regulations.

Comparing the horizontal and vertical individualism and collectivism scale and the Auckland individualism and collectivism scale in two cultures: Switzerland and South Africa

This study investigated the psychometric properties of the Horizontal and Vertical Individualism and Collectivism Scale (HVIC) and the Auckland Individualism and Collectivism Scale (AICS). The sample consisted of 1,403 working individuals from Switzerland (N = 585) and from South Africa (N = 818). Principal component factor analyses indicated that a two-factor structure replicated well across the two countries for both scales. In addition, the HVIC four-factor structure replicated well across countries, whereas the responsibility dimension of individualism of the AICS replicated poorly. Confirmatory factor analyses provided satisfactory support to the original theoretical models for both the HVIC and the AICS. Equivalence measurement indices indicated that the cross-cultural replicability properties of both instruments are generally acceptable. However, canonical correlations and correlations between the HVIC and AICS dimensions confirm that these two instruments differ in their underlying meaning of the individualism and collectivism constructs, suggesting that these two instruments assess individualism and collectivism differently.

Generation of symmetric periodic orbits by a heteroclinic loop formed by two singular points and their invariant manifolds of dimension 1 and 2 in R3

In this paper we will find a continuous of periodic orbits passing near infinity for a class of polynomial vector fields in R3. We consider polynomial vector fields that are invariant under a symmetry with respect to a plane and that possess a “generalized heteroclinic loop” formed by two singular points e+ and e− at infinity and their invariant manifolds � and . � is an invariant manifold of dimension 1 formed by an orbit going from e− to e+, � is contained in R3 and is transversal to . is an invariant manifold of dimension 2 at infinity. In fact, is the 2–dimensional sphere at infinity in the Poincar´e compactification minus the singular points e+ and e−. The main tool for proving the existence of such periodic orbits is the construction of a Poincar´e map along the generalized heteroclinic loop together with the symmetry with respect to .

Symmetric periodic orbits near a heteroclinic loop formed by two singular points and their invariant manifolds of dimension 1 and 2

In this paper we consider vector fields in R3 that are invariant under a suitable symmetry and that posses a “generalized heteroclinic loop” L formed by two singular points (e+ and e −) and their invariant manifolds: one of dimension 2 (a sphere minus the points e+ and e −) and one of dimension 1 (the open diameter of the sphere having endpoints e+ and e −). In particular, we analyze the dynamics of the vector field near the heteroclinic loop L by means of a convenient Poincar´e map, and we prove the existence of infinitely many symmetric periodic orbits near L. We also study two families of vector fields satisfying this dynamics. The first one is a class of quadratic polynomial vector fields in R3, and the second one is the charged rhomboidal four body problem.

Sea-level changes and ammonite faunal turnover during the Lias/Dogger transition in the western Tethys

The aim of this paper was to investigate the possible connections between ammonite faunal turnover and the eustatic events recorded in Tethyan sequences during the middle Toarcian/early Bajocian time interval. For this we have analysed the biostratigraphic ranges, at the subzone level, of approximately 600 ammonite species belonging to 160 genera from several selected sections of the western Tethys (Mediterranean and Submediterranean provinces). The analysis of taxon ranges enabled us to plot curves for ammonite faunal turnovers, inter-subzonal distance, and diversity. Comparing the mentioned curves with Tethyan sequences [Hardenbol et al., 19981, we find that sea-level changes correlate well with origination and extinction events and faunal diversity. Most of the faunal turnovers correlate with stratigraphic events. Extinction events with their corresponding decrease in diversity correlate with regressive intervals and with major or minor sequence boundaries. Origination events and their corresponding increase in diversity were clearly connected with transgressions in Tethyan sequences. In several cases, the major sequence boundary and the subsequent transgressive phase correlate with major ammonite faunal turnover, whereas minor or medium sequence boundaries generally gave rise to minor or medium turnovers.

Design and optimization of selfnanoemulsifying drug delivery systems for enhanced dissolution of gemfibrozil

Self-nanoemulsifying drug delivery systems of gemfibrozil were developed under Quality by Design approach for improvement of dissolution and oral absorption. Preliminary screening was performed to select proper components combination. BoxBehnken experimental design was employed as statistical tool to optimize the formulation variables, X1 (Cremophor® EL), X2 (Capmul® MCM-C8), and X3 (lemon essential oil). Systems were assessed for visual characteristics (emulsification efficacy), turbidity, droplet size, polydispersity index and drug release. Different pH media were also assayed for optimization. Following optimization, the values of formulation components (X1, X2, and X3) were 32.43%, 29.73% and 21.62%, respectively (16.22% of gemfibrozil). Transmission electron microscopy demonstrated spherical droplet morphology. SNEEDS release study was compared to commercial tablets. Optimized SNEDDS formulation of gemfibrozil showed a significant increase in dissolution rate compared to conventional tablets. Both formulations followed Weibull mathematical model release with a significant difference in td parameter in favor of the SNEDDS. Equally amodelistic parameters were calculated being the dissolution efficiency significantly higher for SNEDDS, confirming that the developed SNEDDS formulation was superior to commercial formulation with respect to in vitro dissolution profile. This paper provides an overview of the SNEDDS of the gemfibrozil as a promising alternative to improve oral absorption.