Influence of ofloxacin and pefloxacin on human lymphocyte immunoglobulin secretion and on polymorphonuclear leucocyte superoxide anion production

The influence of two fluoroquinolone derivatives, ofloxacin and pefloxacin, on lymphocyte immunoglobulin secretion and on polymorphonuclear leucocyte superoxide anion production was assessed. Pharmacological concentrations did not influence the studied functions, while suprapharmacological concentrations decreased immunoglobulin production.     

The learning curve of total laparoscopic hysterectomy: comparative analysis of 1647 cases

STUDY OBJECTIVE: To compare the frequency of complications of total laparoscopic hysterectomy performed in the first and more recent years of our experience, and based on that, offer ways to prevent them. DESIGN: Retrospective, comparative study (Canadian Task Force classification II-2). SETTING: University tertiary referral center for endoscopic surgery. PATIENTS: During 1989-1995 and 1996-1999, 695 and 952 women, respectively, with benign pathology. INTERVENTION: Total laparoscopic hysterectomy. MEASUREMENTS AND MAIN RESULTS: No differences in patient characteristics were found between 1989-1995 and 1996-1999. Substantial decreases in major complication rates were noted, 5.6% and 1.3%, respectively. No major vessel injury occurred. Excessive hemorrhage (1.9%) and need for blood transfusion (2.2%) during the first period were statistically higher than in the second period (both 0.1%, p <0.005). Urinary complications (2.2%) including 10 bladder lacerations, 4 ureter injuries, and 1 vesicovaginal fistula occurred more frequently in the first period than in the second period (0.9%), when 6 bladder and 2 ureter lacerations and 1 vesicovaginal fistula occurred (p <0.005). One bowel injury and one bowel obstruction occurred in the first period, but no bowel complications in the second. Between periods, 33 (4.7%) and 8 (1.4%) conversions to laparotomy were necessary. During the first period there were nine reoperations; of six laparotomies, four were due to urinary injuries, one due to heavy vaginal bleeding, and one due to a vesicovaginal fistula; three diagnostic laparoscopies were required due to postoperative abdominal pain. Three reoperations during the second period were two laparoscopies due to heavy vaginal bleeding and one laparotomy due to a vesicovaginal fistula (p <0.005). Statistically significant differences in median (range) uterine weight 179.5 g (22-904 g) and 292.0 g (40-980 g) and operating times 115 minutes (40-270 min) and 90 minutes (40-180 min), respectively, were recorded (p <0.005). CONCLUSION: Laparoscopic hysterectomy was safe, effective, and reproducible after training, and with current technique, had a low rate of complications.     

Management of deep wound infections in spinal lumbar fusions

The rate of deep wound infections in spinal lumbar fusions is around 0.7% to 11.6%, being one of the causes of morbidity in acute phase. The aim of this study was to evaluate the management of spinal infection after internal lumbar fusions. Two hundred and sixty patients, who underwent to spinal surgery with lumbar fusion and iliac bone grafting, were analized, from January 1997 to January 2005. Wound infection was observed in eight (3%) cases. The average of age was 56 years, with a higher prevalence in males (5 patients). Most prevalent was Staphylococcus aureus in 6 patients. The treatment was done by intravenous antibiotic therapy folowed by oral therapy and local irrigation. The average time of hospitalization was 35.8 days. It was possible to erradicate infection without removal of instrumentation in all patients.     

Social representations of generic drugs by pharmacists: determination of the central and peripheral representational systems

This article aimed to identify the central and peripheral systems in social representations of generic drugs by pharmacists, as well as their social and economic profile, thereby establishing potential mechanisms for improving policies for generic drugs in Brazil. The data collection instruments were a questionnaire and a word association test, the inductive cue of which was the term "generic drug". Data collected through the questionnaire produced a profile of pharmacists in the city of Natal, Rio Grande do Norte State, and key information related to the theme. Data analysis for the word association test used Evoc 99 software while content analysis used Bardin, thereby identifying the central system in social representations of generic drugs, consisting of the categories price, quality, and credibility, while the peripheral system consisted of the categories pharmaceutical care, social impact, novelty, accessibility, options, and interchangeability.     

Lymphocyte transformation test with rabbit liver specific lipoprotein (RLSP) in chronic active hepatitis.

Cellular sensitization to rabbit liver specific lipoprotein (RLSP) has been investigated using a lymphocyte transformation test in patients with chronic active hepatitis (CAH). A stimulation index greater than 2 was recorded in twenty out of twenty-five cases (eight of ten HBsAg positive and twelve of fiteen HBsAg negative) while values were lower than 2 in all the normal subjects. These results confirm the finding of sensitization to LSP in chronic active hepatitis irrespective of HBsAg status and show that rabbit LSP can be used as an alternative to the human antigen in the lymphocyte transformation test, and is further evidence that this liver membrane lipoprotein has antigenic determinants which have species-cross-reactivity.     

Étude de la polymérisation du styrène en émulsion inverse

The polymerization of reversed emulsions water in styrene prepared with polystyrene-polyethyleneoxide block copolymers (Cop PS-POE) has been studied. The kinetics of this polymerization has been studied as a function of the parameters: type and concentration of initiator, phase ratio water/styrene, concentration of Cop PS-POE, molecular characteristics of Cop PS-POE. The type of the emulsion can be regulated by the characteristics of the Cop PS-POE and by the phase ratio water/styrene. The initiation of the polymerizations can be achieved by water soluble initiators (K₂S₂O₈). Correlations could be established between the rate of polymerization and the initiator concentration, the amount of water in the reversed emulsions and the concentration of Cop PS-POE. It was shown furthermore that the rate of polymerization increases with the POE content of two-block copolymers and that three-block copolymers are more appropriate for the polymerization in reversed emulsions. Finally the main influence of the water/styrene interface was demonstrated which regulates the transfer of radicals from the aqueous into the organic phase.     

Sustained immunogenicity and efficacy of the HPV-16/18 AS04-adjuvanted vaccine: up to 8.4 years of follow-up

Prophylactic human papillomavirus (HPV) vaccines are now available and vaccination programs are being widely implemented, targeting adolescent girls prior to sexual debut. Since the risk of HPV exposure persists throughout a woman's sexual life, the duration of protection provided by vaccination is critical to the overall vaccine effectiveness. We report the long-term efficacy and immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine (Cervarix (?) ) up to 8.4 y after the first vaccine dose. In an initial placebo-controlled study performed in US, Canada and Brazil, women aged 15-25 y with normal cervical cytology, HPV-16/18 seronegative by ELISA, DNA-negative for 14 oncogenic HPV types by PCR, received either the HPV-16/18 vaccine or placebo (n = 1,113). Subjects were followed up to 6.4 y after the first dose (n = 776). We report an additional 2-y follow-up for women enrolled from the Brazilian centers from the initial study (n = 436). During the current follow-up study (HPV-023, NCT00518336), no new infection or lesions associated with HPV-16/18 occurred in the vaccine group. Vaccine efficacy over the entire follow-up (up to 8.4 y) was 95.1% (84.6, 99.0) for incident infection, 100% (79.8, 100) for 6-mo persistent infection, 100% (56.1, 100) for 12-mo persistent infection and 100% (< 0, 100) for CIN2+ associated with HPV-16/18. All women in the vaccine group remained seropositive to both HPV-16/18, with antibody titers for total and neutralizing antibodies remaining several-folds above natural infection levels. The safety profile was clinically acceptable for both vaccine and control groups. This is, to date, the longest follow-up study for a licensed cervical cancer vaccine.