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Biomedical subjects

I Butcher

Publications and source records attributed to I Butcher.

5 recordsLinked to original sources

Microbial contamination of preservative free eye drops in multiple application containers.

BACKGROUND/AIMS: The majority of eye drops used in the United Kingdom contain preservatives and are bottled in plastic containers. Preservative free drops are used to avoid ocular irritation and allergies in certain individuals. The aim of this study was to investigate the incidence of microbial contamination of preservative free drops dispensed from multiusage containers. METHODS: Eye drop bottles were collected from patients attending the Tennent Institute of Ophthalmology outpatient and inpatient departments. The bottles were collected on day 3 (for inpatients) and day 7 (for outpatients) of use. The drops were inoculated onto different culture plates (chocolate agar, blood agar, fungal culture media, and enriched media) and the resulting microbial growth was identified using standard microbial identification techniques. RESULTS: 95 eye drop bottles were collected, containing a variety of 10 different eye drops. Significant bacterial growth was found in eight bottles. In total, seven different types of organism were identified from the eye drops. The organisms identified were Staphylococcus aureus, coagulase negative staphylococcus, Bacillus spp, Serattia spp, Klebsiella oxytoca, Enterobacter cloacae, and alpha streptococcus. Staph aureus was the commonest microbial organism. CONCLUSION: Preservative free eye drops in multiple application containers are at risk of contamination by potentially pathogenic micro-organisms.

Anti-Bacterial Agents↗

Linezolid penetration into osteo-articular tissues.

Penetration of linezolid into osteo-articular tissue and fluid was studied in 10 patients undergoing primary total knee replacement. Linezolid 600 mg 12 hourly was given orally over the 48 h before operation and intravenously 1 h before induction of anaesthesia. Mean concentrations of linezolid at 90 min after the final dose, in serum, synovial fluid, synovium, muscle and cancellous bone, assayed by HPLC, were at least twice the MIC(90) for staphylococci and streptococci. The concentrations obtained indicate good penetration of this antibiotic and support its use in the management of multidrug-resistant Gram-positive bone, joint and deep-seated soft-tissue infections.

Acetamides↗

Balance in cluster randomized trials.

This paper explores the role of balancing covariates between treatment groups in the design of cluster randomized trials. General expressions are obtained for two criteria to evaluate designs for parallel group studies with two treatments. The first is the variance of the estimated treatment effect and the second is the extent to which the estimated treatment effect is changed by adjusting for covariates. It is argued that the second of these is more important for cluster randomized trials. Methods of obtaining balanced designs from covariates which are available at the start of a study are proposed. An imbalance measure is used to compare the extent to which designs balance important covariates between the arms of a trial. Several approaches to selecting a well balanced design are possible. A method that randomly selects one member from the class of designs with acceptable bias will allow randomization inference as well as model-based inference. The methods are illustrated with data from a trial of school-based sex education.

Adolescent↗

Candida glabrata infection after total hip arthroplasty.

Only two incidents of periprosthetic infection due to Candida glabrata have been reported in the literature. We report successful treatment of a total hip replacement infected with this rare organism by a two-stage revision and synergistic combination antifungal therapy with Amphotericin B and 5-Flucytosine.

Aged↗