The comparison of in the vitro effect of imipenem or meropenem combined with ciprofloxacin or levofloxacin against multidrug-resistant Pseudomonas aeruginosa strains

This study evaluated the in vitro effects of the combination of a carbapenem (imipenem or meropenem) with a quinolone (ciprofloxacin or levofloxacin) using a microbroth dilution chequerboard technique and multidrug-resistant Pseudomonas aeruginosa strains. The ciprofloxacin and meropenem combination was only synergistic against 2 strains (6.2%) and ciprofloxacin and imipenem against 1 strain (3.1%). Levofloxacin and imipenem or meropenem were not synergistic for against any strain. None of the combinations showed an antagonistic effect.     

A multipurpose landmark for skull-base surgery: Henle's spine

OBJECTIVE: To determine whether Henle's spine could be used as a reliable and multipurpose landmark for the other important structures of the skull base. MATERIALS AND METHODS: Ninety-two specimens from 46 cadaveric adult dry skulls were studied. Two imaginary lines and a triangle were defined: a spinopterygoidal line extending from Henle's spine to the root of the medial pterygoid plate, a bispinal line extending from one Henle's spine to the contralateral one, and a parapetrosal triangle lying between the spinopterygoidal line, the bispinal line and the sagittal midline. The parapetrosal triangle encompasses nearly all the main structures of the skull base, including the petrosal internal carotid artery. RESULTS: Along the spinopterygoidal line the distance from Henle's spine to the spine of the sphenoid was found to be about 3 cm, to the foramen spinosum 3.5 cm, to the posterior and anterior margins of the foramen ovale 4 and 4.5 cm, to the root of the lateral pterygoid plate 5 cm, to the root of the medial pterygoid plate 5.5 cm, and to the vomer 6.5-7 cm. Along the bispinal line, the distance from Henle's spine to the stylomastoid foramen was found to be about 1.5 cm, to the lateral and medial margins of the jugular foramen 2.5 and 3.5 cm, to the external orifice of the hypoglossal canal 4 cm, and to the foramen magnum 5 cm. CONCLUSION: Henle's spine with its superficial and central position can be used to localize important anatomical structures during skull-base surgery.     

Transscleral fixation of foldable intraocular lenses

PURPOSE: To report the results of transscleral implantation of foldable intraocular lenses (IOLs). SETTING: Department of Ophthalmology Dokuz Eylül University School of Medicine, Izmir, Turkey. METHODS: Twenty eyes of 20 patients had transscleral fixation of a foldable IOL combined with conventional 3-port pars plana vitrectomy or anterior vitrectomy. Twelve eyes had lens luxation, 8 traumatic and 4 idiopathic. Six eyes were aphakic, 3 after extracapsular cataract extraction and 3 as a result of complicated phacoemulsification. One patient with a mature cataract and pseudoexfoliation had a wide zonular dialysis during phacoemulsification. One patient had an opacified hydrophilic acrylic IOL. RESULTS: The mean age of the patients was 52.9 years (range 17 to 80 years). The mean preoperative best corrected visual acuity (BCVA) was 20/63 (range counting fingers to 20/25). The mean preoperative refraction was +10.8 diopters (D) (range +10 to +13 D) and the mean preoperative astigmatism, 1.8 D (range 1.0 to 5.5 D). Sixteen IOLs were hydrophobic acrylic, 14 of which were 3-piece AcrySof MA60BM (Alcon) and 2 of which were Sensar AR40 (Allergan). Four IOLs, all VisaAcryl(Staar), were hydrophilic acrylic. The mean power of the IOLs was +22.0 D (range 19.0 to 26.0 D). The mean follow-up was 12 months (range 1 to 18 months). The postoperative BCVA ranged between 20/100 and 20/20, and the mean postoperative astigmatism was 1.1 D (range 0.5 to 4.0 D) at the last follow-up visit. The difference was statistically significant (P<.05). Suture exposure and cystoid macular edema were the only complications, each occurring in 2 eyes. CONCLUSION: Transscleral fixation of foldable IOLs takes less time and results in fewer complications and better visual outcomes.     

Partners of men with Klinefelter syndrome can benefit from assisted reproductive technologies

OBJECTIVE: To report the birth of a healthy female infant from a father with nonmosaic Klinefelter syndrome (KS) and document the experience of men with KS undergoing assisted conception. DESIGN: Retrospective. SETTING: Private IVF center. PATIENT(S): Twelve couples with male factor infertility due to Klinefelter syndrome undergoing assisted reproduction treatment. INTERVENTION(S): Controlled ovarian hyperstimulation, testicular sperm extraction, intracytoplasmic sperm injection (ICSI), round spermatid injection (ROSI), and preimplantation genetic diagnosis. MAIN OUTCOME MEASURE(S): Testicular sperm retrieval rate, fertilization rate, and pregnancy outcome. RESULT(S): There was a sufficient amount of motile sperm for injection into mature oocytes in 6 of the 11 testicular biopsies (54.5%). Fertilization rates for ICSI and ROSI cases were 54.2% and 41.6%, respectively. The pregnancy rate per ET was 27.2%. None of the ROSI cases resulted in pregnancy. Two patients had spontaneous abortions at 8 and 18 weeks of gestation, respectively. Only one patient delivered a healthy female baby after 36 weeks of an uneventful pregnancy. CONCLUSION(S): Men with KS can benefit from assisted reproductive technologies, and the testicular sperm retrieval rate among them is promising. Although sex chromosome aberrations among the embryos from men with KS are not common, couples can be offered preimplantation genetic diagnosis before ET.     

Failure of combination therapy with imidocarb dipropionate and toltrazuril to clear <Emphasis Type="Italic">Hepatozoon canis</Emphasis> infection in dogs

Current treatments with imidocarb dipropionate for infected dogs with Hepatozoon canis do not always provide parasitological cure. The objective of this study is to determine whether concomitant use of toltrazuril may potentiate the effect of imidocarb dipropionate in the management of H. canis infection (HCI). Twelve dogs were determined to have naturally HCI based on clinical signs, identification of the parasite in blood smears, and serologic assay. The animals were allocated randomly to one of two groups (n = 6 in each group). Dogs in Imi group were given imidocarb dipropionate at a dose of 6 mg/kg body weight subcutaneously in two injections 14 days apart. Imi plus Toltra group was given imidocarb dipropionate as dose mentioned above and toltrazuril at 10 mg/kg/day orally for the first five treatment days. Clinical findings, blood counts and parasitaemia levels in blood before and 14, 28 and 56 days after the initial treatment were performed to evaluate treatment response. The overall clinical efficacy of imidocarb dipropionate with and without toltrazuril was 83.3% and 66.7%, respectively; with a mean recovery time of 21.0 and 25.6 days, respectively. A substantial main effect of time on mean PCV, Hb, WBC, neutrophil and PLT and gradual reduction of parasitaemia were significantly observed in both groups (P < 0.05), whereas no significant difference was noticed between the studied protocols. The parasitologic cure rate at the end of eight weekly observation period was 16.6% and 33.3% in Imi and Imi plus Toltra groups, respectively. Similar clinicopathologic and parasitologic responses were observed in both treated groups; thus, it was concluded that toltrazuril does not reveal additional benefit to imidocarb therapy in dogs with HCI.     

Factor V Leiden and G20210A prothrombin mutations in patients with recurrent pregnancy loss: data from the southeast of Turkey

Factor V Leiden (FV-Leiden) and prothrombin gene mutations (FII G20210A) are well-established independent risk factors for thrombosis. In the recent years, many studies have suggested that these mutations are associated with an increased risk of recurrent pregnancy loss (RPL). We aimed to investigate the prevalence of these molecular defects in subjects with a history of early RPL. One hundred and fourteen women with three or more consecutive unexplained first-trimester miscarriages were compared to 185 parous women with uncomplicated pregnancies from the same ethnic origin. The presence of FV-Leiden and FII G20210A mutations was assessed by polymerase chain reaction analysis. Overall, 11 out of the 114 women with early RPL (9.6%) had either FV-Leiden or FII G20210A mutation, as compared with 16 out of the 185 women with normal pregnancies (8.6%; p = 0.756). The prevalence of FV-Leiden mutation was 7.9% (9/114) in patient group, compared with 7% (13/185) in control group (p = 0.780). One hundred and two patients were primary and 12 were secondary aborters. All FV-Leiden positive cases were primary aborters (8.8%; 9/102, p = 0.584). Concerning the FII G20210A, two out of 114 (1.7%) were first-trimester RPL (primary aborters) and three out of 185 (1.6%) controls were carriers of the FII G20210A mutation (1.7 vs 1.6%, p = 0.931). The results obtained from patients with first-trimester RPL and the control group have no statistical significant differences in the prevalence of FV-Leiden and FII G20210A mutations. These results suggest that mutations have no role in etiology of first-trimester recurrent abortions.