In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38-A microdilution method

The in vitro susceptibility of 15 strains of six genera of zygomycetes including Rhizopus oryzae (Rhizopus arrhizus), Rhizopus stolonifer, Mucor circinelloides (three), Absidia corymbifera (three), Rhizomucor pusillus (three), Cunninghamella bertholletiae (two), and Syncephalastrum racemosum (two) to nine antifungal agents were determined by the NCCLS M38-A broth microdilution method. Geometric means of the minimal inhibitory concentrations (MIC) were: amphotericin B 0.07 mg l(-1) (range 0.03-0.5 mg l(-1)), nystatin 0.83 mg l(-1) (range 0.25-4 mg l(-1)), itraconazole 0.59 mg l(-1) (range 0.03 to >8 mg l(-1)), voriconazole 6.50 mg l(-1) (range 2 to >8 mg l(-1)), ciclopiroxolamine 1.59 mg l(-1) (range 0.5-4 mg l(-1)), and amorolfine 9.19 mg l(-1) (range 1 to >16 mg l(-1)). All strains were resistant to 5-flucytosine, fluconazole (MIC >64 mg l(-1)) and caspofungin (MIC >16 mg l(-1)).     

Ungual and trans-ungual iontophoretic delivery of terbinafine for the treatment of onychomycosis

The application of iontophoresis was demonstrated in the nail drug delivery of terbinafine (TH) recently. This study explored a systematic assessment of this approach to enhance the drug delivery using a novel topical formulation, and the subsequent release of TH from the drug loaded nails. For the first time, a nail on-agar plate model was used to study the release of drug from the iontophoresis (0.5 mA/cm²) loaded nails. In addition, the activity of the drug released from the drug loaded nail plate was studied against Trichophyton rubrum. An increase in applied current density and current duration enhanced the transport of TH into and through the nail plate. In vitro release of drug from the iontophoretic loaded nails into agar plates exhibited 2-phase release pattern. The amount of drug released in both of the in vitro models was comparable, and the nails loaded using iontophoresis continued to release levels of TH > 2 orders of magnitude above the minimum inhibitory concentration over at least 52 days. Results indicate that iontophoresis enhances the delivery of terbinafine into and through the nail plate and suggest that the use of this treatment approach could result in a safe and more efficacious outcome with less frequent treatments. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4130–4140, 2009     

Randomized controlled trial comparing the Franseen needle with the Fork-tip needle for EUS-guided fine-needle biopsy

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Links between the organization of the family home environment and child obesity: a systematic review

Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well‐specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2–12. Six hundred thirty‐seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.     

The expectations of patients undergoing revision hip arthroplasty

Sixty patients were prospectively assessed using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) scale for osteoarthritis of the hip and the Short Form 36 (SF-36) general health status scale as well as the expectation WOMAC, which asked patients to estimate how they expected to feel 6 months after revision hip arthroplasty. There was a wide range of expectations, but we were unable to find any significant correlation between the patients' preoperative pain and stiffness levels and their expectations for pain and stiffness after revision hip arthroplasty. There was no significant correlation between the SF-36 scores and the patients' expectations. Our findings suggest that the expectations of patients awaiting revision hip arthroplasties are high and are not related closely to the level of preoperative disability.