Incidence and risk factors for pulmonary exacerbation treatment failures in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa

Background: Pulmonary exacerbations (PEx) are responsible for much of the morbidity and mortality associated with cystic fibrosis (CF). However, there is a paucity of data on outcomes in CF PEx and factors influencing outcomes.

Methods: We reviewed all PEx in patients infected with Pseudomonas aeruginosa treated with parenteral antibiotics over 4 years at our center. Treatment failures were categorized a priori as those PEx requiring antibiotic regimen change, prolongation of therapy > 20 days because of failure to respond, an early recurrent event within < 45 days, or failure to recover lung function to > 90% of baseline FEV1.

Results: A total of 101 patients were followed for 452 PEx. Treatment failures were observed in 125 (28%) of PEx; antibiotic regimen change was observed in 27 (6%), prolongation of therapy in 29 (6%), early recurrent events in 63 (14%), and failure to recover lung function to > 90% of baseline FEV1 in 66 (15%). Demographic factors associated with one or more treatment failures per year included advanced airways disease, use of enteric feeds, CF-related diabetes, and CF liver disease but did not include female sex or F508del homozygosity. Increased treatment failure risk was associated with lower admission FEV1 and increased markers of inflammation. At therapeutic completion, increased inflammatory markers correlated with treatment failure. Failure rates decreased with increasing number of active antimicrobial agents used based on in vitro susceptibility (zero, 28/65 [43%]; one, 38/140 [27%]; two, 59/245 [24%]; three, 0/2 [0%]; P = .02).

Conclusions: One-fourth of PEx fail to respond adequately to initial management. Patient demographic and episode-specific clinical information can be used to identify individuals at increased risk of initial management failure.

Power Stored and Quality Factors in Frequency Selective Surfaces at THz Frequencies

A study of the external, loaded and unloaded quality factors for frequency selective surfaces (FSSs) is presented. The study is focused on THz frequencies between 5 and 30 THz, where ohmic losses arising from the conductors become important. The influence of material properties, such as metal thickness, conductivity dispersion and surface roughness, is investigated. An equivalent circuit that models the FSS in the presence of ohmic losses is introduced and validated by means of full-wave results. Using both full-wave methods as well as a circuit model, the reactive energy stored in the vicinity of the FSS at resonance upon plane-wave incidence is presented. By studying a doubly periodic array of aluminium strips, it is revealed that the reactive power stored at resonance increases rapidly with increasing periodicity. Moreover, it is demonstrated that arrays with larger periodicity-and therefore less metallisation per unit area-exhibit stronger thermal absorption. Despite this absorption, arrays with higher periodicities produce higher unloaded quality factors. Finally, experimental results of a fabricated prototype operating at 14 THz are presented.

SYNTHESIS AND PROPERTIES OF DITHYMIDINE PHOSPHATE ANALOGS CONTAINING 3'-THIOTHYMIDINE

Dithymidine-3'-S-phosphorothioate (d(TspT)) has been prepared from a 5'-O-monomethoxytritylthymidine-3'-S- phosphorothioamidite (7) by activation with 5-(p- nitrophenyl)tetrazole in the presence of 3'-O- acetylthymidine. The resulting dinucleoside phosphorothioite is readily oxidised to the corresponding 3'-S-phosphorothioate using either tetrabutylammonium (TBA) perlodate or TBA oxone and has been deprotected under standard conditions to yield d(TspT). This dithymidine phosphate analogue is comparatively resistant to hydrolysis by nuclease P1, but the P-S bond is readily cleaved by aqueous solutions of either iodine or silver nitrate. Dithymidine-3'-S-phosphorodithioate (d[Tsp(s)T] was prepared in an analogous fashion using sulphur to oxidise the intermediate dinucleoside phosphoro thiolte. Absolute stereochemistry has been assigned to the diastereoisomers of d by comparing their physical and chemical properties to those of the dinucleoside phosphorothioates.

OXOIRON(IV) PORPHYRINS DERIVED FROM CHARGED IRON(III) TETRAARYLPORPHYRINS AND CHEMICAL OXIDANTS IN AQUEOUS AND METHANOLIC SOLUTIONS

The oxidation of six charged iron(III) tetraarylporphyrins with chemical oxidants has been investigated. In aqueous solution each can be converted by tert-butyl hydroperoxide or monopersulphate into its corresponding oxoiron(IV) porphyrin, whereas in methanol only the iron(III) tetra(N-methylpyridyl)porphyrins form detectable ferryl porphyrins at ambient temperatures. On standing, the iron species revert to the parent porphyrin with a small loss due to non-reversible oxidative destruction. That the oxidised porphyrin intermediates are oxoiron(IV) species has been determined using UV-VIS, resonance Raman, H1 NMR and EPR spectroscopy.

Chemical evolution in collapsing cores

We study the chemical evolution in the central core of contracting interstellar clouds. The chemical rate equations and the hydrodynamic equations are integrated simultaneously. The. contraction is followed from very low density (n = 10 cm(-3)) to a high-density core with n > 10(7) cm(-3). The chemical evolution is studied for various physical and chemical conditions, including the effects of varying the cosmic ray ionization rate, in order to understand the observed structures in TMC-1 and the extended ridge cloud in Orion. Our results give good agreement with the observations for models with fast ion-dipole reaction rates, low cosmic ray ionization rates and low depletion of N and S. It is also found that there should be different stages of evolution with different densities in these sources.

Physical and immunoaffinity extraction of paralytic shellfish poisoning toxins from cultures of the dinoflagellate Alexandrium tamarense

In the present study the extraction of paralytic shellfish poisoning (PSP) toxins from a toxic strain of the marine dinoflagellate Alexandrium tamarense CCMP-1493 using various mechanical and/or physical procedures was investigated. PBS buffer was investigated as the extraction solvent in order for these procedures to be used directly with immuno-magnetic Ferrospheres-N. The extraction was performed following the determination of when toxin content by the algae was at its highest during batch culture. The methods used for cell lysis and toxin extraction included freeze-thawing, freeze-boiling, steel ball bearing beating, glass bead beating, and sonication. The steel ball bearing beating was determined to release a similar amount of toxin when compared to a modified standard extraction method which was reported to release 100% of toxins from the algal cells and was therefore used in the next phase of the study. This next phase was to determine the feasibility of utilising an antibody coupled to novel magnetic microspheres (Ferrospheres-N) as a simple, rapid immune-capture procedure for PSP toxins extracted from the algae. The effects of increasing mass of Ferrospheres-N on the immuno-capture of the PSP toxins from the toxic algal strain extracts were investigated. Toxin recovery was found to increase when an increasing mass of Ferrospheres-N was used until 96.2% (+/- 1.3 SD) of the toxin extracted from the cells was captured and eluted. Toxin recovery was determined by comparison to an appropriate PSP toxin standard curve following analysis by the AOAC HPLC method. (C) 2011 Elsevier B.V. All rights reserved.

Comparison of the efficiences of enzymatic and chemical hydrolysis of (nortestosterone and diethylstilboestrol) glucuronides in bovine urine

Residues of 19-nortestosterone (19-NT) and diethylstilboestrol (DES) are excreted in bovine urine, mainly conjugated to glucuronic acid. Prior to quantification, urine must be deconjugated, which is commonly performed by enzymatic or chemical hydrolysis. The efficiencies of two enzymatic and two chemical deconjugation methods were studied. The range of efficiencies obtained for DES were 51.8% (beta -glucuronidase, incubation at 37 degreesC overnight) and 2.7% (methanolic HCl), respectively. Similarly, efficiencies for NT ranged from 43.1% (beta -glucuronidase, incubation at 55 degreesC for 2 h) to 12.7% (methanolic HCl). The results highlight that within control laboratories significant underestimation of drug residue content in samples may occur, due to poor deconjugation. (C) 2001 Elsevier Science B.V. All rights reserved.