The activity of gentamicin and N-formimidoyl thienamycin (MK 0787) on Pseudomonas aeruginosa at pH 7.4 and 7.0.
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Biomedical subjects
Publications and source records attributed to M Shulman.
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The activities of cefotaxime, moxalactam, MK 0787 (N-formimidoyl thienamycin), ampicillin, oxacillin, vancomycin, and clindamycin were compared against gram-positive cocci. MK 0787 was the most active and moxalactam was the least active of these drugs, except against methicillin-resistant Staphylococcus aureus, where vancomycin was most active, and penicillin-resistant pneumococci, where cefotaxime was more active.
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Current clinical approaches to the assessment of language comprehension in children are characterized by the measurement of "receptive" knowledge of lexical items and syntactic structure. A more comprehensive approach would go beyond measuring the child's ability to comprehend the literal meaning of sentences to include two other aspects of obtaining information from spoken utterances: presupposition and inference and illocutionary acts. A selected review of clinical instruments measuring language comprehension that are in current use is presented, revealing that these tests of vocabulary, basic concepts, and comprehension of syntactic structure are limited to the literal-meaning aspect of spoken messages. Tests of intelligence and reading skills for children and tests for adult aphasia include more complex comprehension items that require linguistic integration and inference. There are no tests that measure the listener's ability to determine the speaker's illocutionary intent. An integrated approach to the measurement of language comprehension is not available in the form of clinical tests.
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Groups of patients with intractable epilepsy or spasticity of varying etiologies underwent psychological testing before and during chronic cerebellar cortex stimulation, a neurosurgical technique designed for the relief of these symptoms. The battery of psychological tests permitted a standardized assessment of intellectual, memory, and perceptual functions. Other behavioral dimensions were assessed through structured interviews. No apparent declines in higher integrative functions followed shorter or longer term cerebellar stimulation. In contrast, stimulated patients tended to show increments in tests of recent memory and verbal output beyond that of unoperated comparison groups. Subjective reports of increased "alertness" and reduced depression and anxiety were also frequently given. Psychological and neural factors may both contribute to the observed behavioral alterations. It was concluded that the cerebellum participates in behavioral functions by modifying cortical and subcortical mechanisms relevant to integrative behavior and emotions. Specific hypotheses were presented.
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BACKGROUND AND OBJECTIVES: Butamben is a non-water-soluble local anesthetic that can be prepared as an aqueous suspension for nerve blocks. This report describes the use of 5% butamben suspension for the treatment of chronic pain of cancer and noncancer origin. METHODS: The clinical courses of 75 consecutive patients were analyzed following 5% butamben nerve blocks (35 epidural blocks only, 33 peripheral nerve blocks only, and 7 had both epidural and peripheral nerve blocks). Epidural blocks were performed as a series of four with additional blocks offered if needed. Peripheral nerve blocks were done as a single block with repeat injections if needed. Injection volumes varied between 15 and 25 mL for epidural injections and 5 and 20 mL for peripheral nerve blocks. Successful therapy was defined as a -75% reduction in subjective pain assessments for -4 weeks or until death. Daily opioid requirements were also recorded. RESULTS: Fifty-four of the 75 patients (72%) were successfully treated. This included 48 of 67 cancer patients (71.6%) and 6 of 8 noncancer patients (75%). Median duration of pain relief was 12 weeks (range, 1-96) in the cancer patients and 10 weeks (range, 6-166) in the noncancer patients. Mean reduction in opioid requirements in successfully treated cancer patients was 74+/-5%. Pain on epidural injection occurred in half of the patients and was the most prevalent complication of treatment. Five patients had signs of intravascular injection. There were no serious long-term sequelae. CONCLUSIONS: When used as described in this report, 5% butamben suspension appears to be effective for treatment of chronic pain of both cancer and noncancer origin and has a low incidence of adverse sequelae.
Three groups of dogs were each given repeat epidural injections of a 10% butamben suspension. A fourth group received a single subarachnoid injection of the butamben suspension. All dogs were later sacrificed and the spinal cord, meninges and spinal nerves were examined. The dogs receiving the epidural injections had no pathology. Those dogs that received subarachnoid injections had adhesive arachnoiditis. None demonstrated any evidence of neurolysis. Two cancer patients who had each received multiple injections of a 10% butamben suspension for the successful treatment of cancer pain prior to their deaths had autopsies and the spinal cords, meninges and spinal nerves were examined. No significant pathology due to the butamben was noted. Epidural butamben does not appear to cause any local tissue damage provided that subarachnoid needle placement has been ruled out. Subarachnoid butamben should be avoided.