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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Implant-associated infections offer resistance to antibiotic treatment and possibly do so because the causative bacteria which reside on the artificial surface are enclosed in a protective matrix (biofilm) shielding the bacteria against the action of host defenses and antibiotic action. We have investigated in vitro the effect of various antimicrobial agents on biofilms of Staphylococcus epidermidis, which is the main organism responsible for implant-associated infections. Rifampin was found to exert superior activity, albeit incomplete, against S. epidermidis biofilms using an assay system which enabled the determination of the kinetics of antibiotic action over five days. In a large screening study looking for agents capable of completing the action of rifampin, gentamicin was unexpectedly found to be antagonistic to rifampin. The present study was undertaken to investigate further the activity of gentamicin and five other aminoglycoside antibiotics using a wider range of concentrations (2.5-20 micrograms/mL). The main findings were a marked synergy with rifampin demonstrated by streptomycin, producing a bactericidal outcome, which contrasted sharply with the indifference or antagonism shown by the other aminoglycosides. We then studied in further detail the effect of separate combinations of streptomycin and gentamicin with rifampin over a wider concentration range of each agent (1.25-40 micrograms/mL). Streptomycin showed strong rapid synergy with rifampin even at the lowest concentration of each antibiotic. Gentamicin demonstrated a concentration-related antagonism towards rifampin which was independent of rifampin concentration. The data support the conclusion that streptomycin, like cell-wall active antibiotics, exerts a potent synergy with rifampin against S. epidermidis biofilms, and that the other aminoglycosides, predominantly gentamicin, strongly antagonize rifampin action.(ABSTRACT TRUNCATED AT 250 WORDS)
Adv Perit Dial 1994
PMID:The differential activity of aminoglycoside antibiotics with rifampin explored in a kinetic in vitro model of implant-associated infection (Staphylococcus epidermidis). 799 23

Quality of life assessments were performed in 24 haemodialysis patients (10 males, 14 females, age 45 +/- 15 years) undergoing rHuEpo treatment. The results in the rHuEpo-treated patients were compared with those in eight haemodialysis patients not on rHuEpo and with the results of a nationwide study of dialysis patients in Sweden (carried out before rHuEpo was registered). Survey questionnaires (112 items, divided into three dimensions, i.e. physical, social, and emotional wellbeing) were completed before treatment (Hb 73 +/- 1.1 g/l), when the target Hb value of 10 g/dl was reached (1-7 months) and in 14 patients 1 year after correction of the anaemia. Before treatment, the rHuEpo group had significantly more complaints about poor appetite, fatigue, and irritability than the controls. After the anaemia was corrected, the rHuEpo group had significantly improved physical and emotional wellbeing. The most significant changes occurred in satisfaction with health, physical activities of daily life, and fatigue. Alterations in emotional symptoms, such as depression and apathy, were less pronounced. Only minor changes were observed in their social wellbeing. One year after correction of the anaemia, the improvements in physical and emotional wellbeing were still present in the rHuEpo-treated patients. A positive effect was also noted on hospitalization rate. Scores for the subdimensions of satisfaction with health, sexual adjustment, physical symptoms, and emotional wellbeing improved in the rHuEpo-treated group and reached a level that was the same, or even higher, than the scores in the dialysis patients in the nationwide study. In conclusion, the quality of life improved during rHuEpo treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1993
PMID:Long-term effects on quality of life in haemodialysis patients of correction of anaemia with erythropoietin. 839 47

For the initial treatment of peritonitis complicating peritoneal dialysis (PD), we use intraperitoneally administered gentamicin (broad spectrum and low costs) and rifampin (intracellular bactericidal activity). In order to assess the efficacy of this treatment, the outcome of 248 suspected episodes of peritonitis (abdominal pain, cloudy effluent, and a leukocyte count over 100/mm3) was evaluated. Of 227 cases with a positive culture of the PD effluent, one bacterial species was cultured in 188 cases (75.8%), more than one in 32 cases (12.9%), and in 7 cases (2.8%) yeasts. In 87.2% of the culture-positive cases, a good clinical response to the initialized antibiotic therapy was found. In 20 cases (8.1%) antibiotic treatment was discontinued within one week because no micro-organisms were cultured. In one case no effluent was cultured. Although in vitro resistance or indifference to both antibiotics was found in 45 cases (19.8%), in only 29 culture-positive cases (12.8%) the clinical condition did not improve on initial therapy. Of the peritonitis episodes in which micro-organisms resistant to both antibiotics were cultured, 23 were Staphylococcus epidermidis, 5 were E. coli, 7 were yeasts, and there were miscellaneous (mostly enteral) bacteria in 10 cases. In the studied period no significant changes were found in the susceptibility of the cultured microorganisms to gentamicin and rifampin. Susceptibility profile per episode, however, showed an increasing resistance against both antibiotics. It is concluded that the combination of gentamicin and rifampin as initial treatment of peritonitis is effective in most (87%) cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Adv Perit Dial 1995
PMID:The efficacy of intraperitoneally administered gentamicin and rifampin as initial treatment of peritoneal dialysis-related peritonitis. 853