Pharmacokinetics of ciprofloxacin in ICU patients on continuous veno-venous haemodiafiltration

Objectives: To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). Design and setting: Open, prospective clinical study in a multidisciplinary, intensive care unit in a university-affiliated tertiary referral hospital. Patients: Sis critically ill patients with acute renal failure on CVVHDF. Interventions: Timed blood and ultrafiltrate samples were collected to allow pharmacokinetics and clearances to be calculated of initial and subsequent doses of 200 mg intravenous ciprofloxacin. CVVHD was performed with 1 l/h of dialysate and 2 l/h of predilution filtration solution, producing 3 lih of dialysis effluent. The blood was pumped at 200 ml/min using a Gambro BMM-10 blood pump through a Hospal AN69HF haemofilter,. Measurements and results: Ten pharmacokinetic profiles were measured. The CVVHDF displayed a urea clearance of 42 +/- 3 ml/min, and removed ciprofloxacin with a clearance of 37 +/- 7 ml/min. This rate was 2-2.5 greater than previously published for ciprofloxacin in other forms of CRRT. On average the CVVHDF was responsible for clearing a fifth of all ciprofloxacin eliminated (21 +/- 10%). The total body clearance of ciprofloxacin was 12.2 +/- 4.3 l/h. The trough concentration following the initial dose was 0.7 +/- 0.3 mg/l. The area under the plasma concentration time curves over a 24-h period ranged from 21 to 55 mg .h l(-1). Conclusions: Intravenous ciprofloxacin 600 mg/day in critically ill patients using this form of CRRT produced adequate plasma levels for many resistant microbes found in intensive care units.

Dynamics of a mesoscopic charge quantum bit under continuous quantum measurement

We present the conditional quantum dynamics of an electron tunneling between two quantum dots subject to a measurement using a low transparency point contact or tunnel junction. The double dot system forms a single qubit and the measurement corresponds to a continuous in time readout of the occupancy of the quantum dot. We illustrate the difference between conditional and unconditional dynamics of the qubit. The conditional dynamics is discussed in two regimes depending on the rate of tunneling through the point contact: quantum jumps, in which individual electron tunneling current events can be distinguished, and a diffusive dynamics in which individual events are ignored, and the time-averaged current is considered as a continuous diffusive variable. We include the effect of inefficient measurement and the influence of the relative phase between the two tunneling amplitudes of the double dot/point contact system.

Educating speech-language pathologists for a multicultural world

This paper presents critical elements and current needs in educating speech-language pathologists for a multicultural world. A proposed paradigm shift in clinical teaching using the UK model is also introduced. In addition, a case study on the American Speech Language Hearing Association's efforts in implementing the Multicultural Action Agenda by networking with the Asian Pacific Islander caucus is described. A survey of multicultural elements in programs in Australia and New Zealand is included. finally, suggestions for collaboration with those in established professional bodies to meet the increasing needs of a multicultural world are provided. copyright (C) 2001 S. Karger AG. Basel.

Subcortical brain mechanisms in speech and language

This paper reviews current research and contemporary theories of subcortical participation in the motor control of speech production and language processing. As a necessary precursor to the discussion of the functional roles of the basal ganglia and thalamus, the neuroanatomy of the basal ganglial-thalamocortical circuitry is described. Contemporary models of hypokinetic and hyperkinetic movement disorders based on recent neuroanatomical descriptions of the multi-segmented circuits that characterise basal ganglion anatomy are described. Reported effects of surgically induced lesions in the globus pallidus and thalamus on speech production are reviewed. In addition, contemporary models proposed to explain the possible contribution of various subcortical structures to language processing are described and discussed in the context of evidence gained from observation of the effects of circumscribed surgically induced lesions in the basal ganglia and thalamus on language function. The potential of studies based on examination of the speech/language outcomes of patients undergoing pallidotomy and thalamotomy to further inform the debate relating to the role of subcortical structures in speech motor control and language processing is highlighted. Copyright (C) 2001 S. Karger AG, Basel.

The management of rice grown on raised beds with continuous furrow irrigation

A field experiment compared two rice (Oryza sativa L.) cropping systems: paddy or raised beds with continuous furrow irrigation; and trialled four cultivars: Starbonnet, Lemont, Amaroo and Ceysvoni, and one test line YRL39; that may vary in adaptation to growth on raised beds. The grain yield of rice ranged from 740 to 1250 g/m(2) and was slightly greater in paddy than on raised beds. Although there were early growth responses to fertilizer nitrogen on raised beds, the crop nitrogen content at maturity mostly exceeded 20 g/m(2) in both systems, so nitrogen was unlikely to have limited yield. Ceysvoni yielded best in both systems, a result of good post-anthesis growth and larger grain size, although its whole-grain mill-out percentage was poor relative to the other cultivars. Starbonnet and Lemont yielded poorly on raised beds, associated with too few tillers and too much leaf area. When grown on raised beds all cultivars experienced a delay in anthesis resulting in more tillers, leaf area and dry weight at anthesis, and probably a greater yield potential. The growth of rice after anthesis, however, was similar on raised beds and in paddy, so reductions in harvest index and grain size on raised beds were recorded. The data indicated that water supply was not a major limitation to rice growth on raised beds, but slower crop development was an issue that would affect the use of raised beds in a cropping system, especially in rice-growing areas where temperatures are too cool for optimal crop development. (C) 2001 Elsevier Science B.V. All rights reserved.

The mechanisms of combustion and continuous reactions during mechanical alloying

Some materials exhibit a combustion event during mechanical alloying, which results in the rapid transformation of reactants into products, while others show a slow transformation of reactants into products, In this paper, the continuous W + C --> WC reaction is compared to the Ti + C --> TiC combustion reaction. Rietveld refinement of X-ray diffraction patterns is used to show that these particular reactions proceed through different pathways, determined by crystallographic factors of the reactants. When a crystallographic relationship exists between the reactants and the products, such as that between W and WC, the product forms slowly over a period of time. In contrast, insertion of C into the Ti structure is associated with atomic rearrangements within the crowded lattice planes and the subsequent catastrophic failure of the reactant lattices results in combustion to form TiC. (C) 2001 Academic Press.

Early toxicity from preoperative radiotherapy with continuous infusion 5-fluorouracil for resectable adenocarcinoma of the rectum: A phase II trial for the Trans-Tasman Radiation Oncology Group

Purpose: To assess the toxicity and the efficacy of preoperative radiotherapy with continuous infusion 5-fluorouracil (5-FU) for locally advanced adenocarcinoma of the rectum. Methods and Materials: Eligible patients had newly diagnosed localized adenocarcinoma of the rectum within 12 cm of the anal verge, Stage T3-4, and were suitable for curative resection. Eighty-two patients were treated with radiotherapy-50.4 Gy in 28 fractions in 5.6 weeks, given concurrently with continuous infusion 5-FU, using either 96-h/week infusion at 300 mg/m(2)/day or 7-days/week infusion at 225 mg/m(2)/day. Results: The median age was 59 years (range, 27-87), and 67% of patients were male. Pretreatment stages of the rectal cancer were T3, 89% and resectable T4, 11%, with endorectal ultrasound confirmation in 67% of patients. Grade 3 acute toxicity occurred in 5 of 82 patients (6%; 95% confidence interval [CI], 2-14%). Types of surgical resection were anterior resection, 61%; abdominoperineal resection, 35%; and other procedures, 4%. There was no operative mortality. Anastomotic leakage after low anterior resection occurred in 3 of 50 patients (6%; 95% CI, 1-17%). The pathologic complete response rate was 16% (95% CI, 9-26%). Pathologic Stages T2 or less occurred in 51%. Conclusion: Preoperative radiotherapy with continuous infusion 5-FU for locally advanced rectal cancer is a safe regimen, with a significant downstaging effect. It does not seem to lead to a significant increase in serious surgical complications. (C) 2001 Elsevier Science Inc.