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Biomedical subjects

B Balke

Publications and source records attributed to B Balke.

At least 19 recordsLinked to original sources

Evaluation of the E test for the assessment of synergy of antibiotic combinations against multiresistant Pseudomonas aeruginosa isolates from cystic fibrosis patients.

The determination of synergistic effects of antimicrobial drug combinations can lead to improved therapeutic options in the antibiotic treatment of cystic fibrosis patients who are chronically infected with multiresistant Pseudomonas aeruginosa isolates. The aim of this study was to evaluate the performance of the E test versus the standard agar dilution checkerboard susceptibility test in the assessment of synergy and, in addition, to determine the activity of two antimicrobial combinations against 163 multiresistant P. aeruginosa isolates from cystic fibrosis patients. The agreement between the checkerboard method and the E test was excellent (>90%) for nonmucoid as well as mucoid isolates from cystic fibrosis patients. The rate of synergy was higher for the antibiotic combination of ceftazidime and tobramycin (28.8% of the cystic fibrosis strains) than for the combination of meropenem and tobramycin (19.0%). However, the probability of synergy for the second antibiotic combination increased significantly when the synergy of the first antibiotic combination had already been demonstrated (Fischer's exact test, p=0.049). The results show that the E test is a valuable and practical method for routine microbiological diagnostics and can aid in the selection of improved antibiotic options in the treatment of cystic fibrosis patients chronically infected with P. aeruginosa.

Anti-Bacterial Agents↗

Comparison of the Micronaut Merlin automated broth microtiter system with the standard agar dilution method for antimicrobial susceptibility testing of mucoid and nonmucoid Pseudomonas aeruginosa isolates from cystic fibrosis patients.

The aim of this study was to compare a commercially available automated broth microdilution system (Merlin; Micronaut, Germany) with the standard agar dilution method for susceptibility testing of pulmonary isolates from cystic fibrosis patients. Accurate susceptibility testing of bacterial isolates from cystic fibrosis patients is known to pose problems. Although commercially available automated test systems could facilitate susceptibility testing of such isolates in routine diagnostics, these systems have not been recommended thus far. However, a pilot study recently indicated that the Merlin system, which is based on an endpoint measurement rather than on growth curves, might be applicable in the susceptibility testing of isolates from cystic fibrosis patients. In the present study, the Merlin system was further evaluated using an extended panel of nonmucoid and mucoid Pseudomonas aeruginosa isolates. The results showed that the MICs obtained with the Merlin system tended to be lower than those obtained with the agar dilution method, a finding that became increasingly apparent when mucoid Pseudomonas aeruginosa strains were tested. The correlation coefficients (r values) of the MIC results for all strains tested were between 0.6 and 0.8 for five of the seven antimicrobial agents, with r values exceeding 0.8 for only meropenem and ciprofloxacin. However, since the overall rate of serious discrepancies was within an acceptable range, the Merlin system appears to be applicable for routine clinical use in susceptibility testing of P. aeruginosa isolates from cystic fibrosis patients.

Anti-Bacterial Agents↗

Aerobic requirements of overground versus treadmill running.

There is general agreement that the oxygen demand of level running is similar for both the treadmill (TM) and overground situations at speeds under 260 m X min-1. However, controversy exists with regard to inclined running. The prevailing view, represented by the ACSM prediction formulas, is that overground hill running is theoretically more costly than inclined treadmill running. This study was designed to investigate the problem from an empirical standpoint. Seven male subjects performed overground and TM running at two grades (0 and 5.7%) over a range of speeds between 136-286 m X min-1. For the outdoor trials, subjects covered a distance of 950 m at a constant pace, and expired gas was collected over the last 150 m. Matching trials were then performed on the treadmill at the same speed and % grade. Regression lines were calculated for speed vs oxygen consumption (VO2). For TM and overground level running, these were: VO2 (ml.kg-1.min-1)= 0.222 X speed (m.min-1) - 1.33 and VO2 (ml.kg-1.min-1) = 0.202 X speed (m.min-1) + 3.21 respectively. The regression lines from TM and overground inclined running were: VO2 (ml.kg-1.min-1) = 0.237 X speed (m.min-1) + 7.53. and VO2 (ml.kg-1.min-1) = 0.233 X speed (m.min-1) + 7.78 respectively. A 2 X 3 X 2 ANOVA revealed that the differences between mean values for VO2 for level TM running vs level overground running and grade TM running vs grade overground running were not statistically significant (0.10 less than P less than 0.25).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Walking efficiency before and after total hip replacement as determined by oxygen consumption.

Seventy-seven patients receiving either unilateral or bilateral total hip replacement were studied before and for as long as four years after operation. Their walking velocity and efficiency (the latter determined by measuring oxygen consumption) improved after operation. Total hip replacement allowed relatively equal postoperative efficiency and velocity for patients with unilateral and bilateral disease. While no consistent relationships were found between the components of the Iowa hip-rating scale, significant correlations were found between the composite Iowa hip-rating score and oxygen consumption. Data indicate that measurement of self-selected velocity in patients with hip disease is a satisfactory indicator of walking efficiency.

Aged↗