Intravegetation antimicrobial distribution in aortic endocarditis analyzed by computer-generated model. Implications for treatment.

Abstract:

:The distribution of antibiotics into cardiac valvular tissues is incompletely understood. By integrative computer modeling, we have used previously obtained pharmacokinetic data in experimental endocarditis to characterize aminoglycoside distribution within various geographic sectors of aortic vegetations of rabbits and humans in the current study. In rabbits with pseudomonal aortic endocarditis receiving a standard regimen of amikacin (15 mg/kg every eight hours), sub-MBC levels of the drug for the infecting organism were calculated in the center of 0.38-cm vegetations; this occurred despite supra-MBC levels calculated in plasma and more peripheral loci of the vegetation. In contrast, with a high-dose regimen of amikacin (40 mg/kg every eight hours), supra-MBC drug levels were calculated throughout the entire vegetation for at least 50 percent of the dosing interval. Using similar computer-generated approaches, these data in the rabbit were approximately in simulated aminoglycoside penetration of 10-mm human aortic vegetations. Aminoglycoside regimens designed to yield supra-MBC serum levels in both normal and rapid drug eliminators consistently achieved sub-MBC levels in the center of the vegetation. Computer simulations also confirmed that daily doses of aminoglycoside at least two to four times higher than those ordinarily recommended are necessary to consistently achieve uniform supra-MBC intravegetation levels for an entire dosing interval. Such computer-generated data support the concept of maldistribution of aminoglycosides in aortic endocarditis and provide a rationale for investigating the use of high-dose regimens of aminoglycoside in treating experimental endocarditis.

journal_name

Chest

journal_title

Chest

authors

Bayer AS,Crowell D,Nast CC,Norman DC,Borrelli RL

doi

10.1378/chest.97.3.611

subject

Has Abstract

pub_date

1990-03-01 00:00:00

pages

611-7

issue

3

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)40925-0

journal_volume

97

pub_type

杂志文章

相关文献

CHEST文献大全
  • Left atrial bacterial mural endocarditis.

    abstract::An unusual case of Staphylococcus aureus endocarditis confined to the mural left atrium is presented. Echocardiographic studies revealed a 1.5 x 2.0-cm vegetation mimicking a myxoma situated in the path of a mitral regurgitant jet on a color Doppler test. Emboli to upper and lower extremities and brain complicated the...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.3.757

    authors: Bierbrier GS,Novick RJ,Guiraudon C,Wisenberg G,Boughner D

    更新日期:1991-03-01 00:00:00

  • Does a low-density gas mixture or oxygen supplementation improve exercise training in COPD?

    abstract:BACKGROUND:Low-density gas mixtures and oxygen (O₂) supplementation are known to improve physical performance and ventilatory adaptation during incremental maximal exercise in COPD. We investigated whether their combined use during intense physical training is also effective in ameliorating exercise tolerance in patien...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.10-0120

    authors: Scorsone D,Bartolini S,Saporiti R,Braido F,Baroffio M,Pellegrino R,Brusasco V,Crimi E

    更新日期:2010-11-01 00:00:00

  • Oxidative DNA damage and somatic mutations: a link to the molecular pathogenesis of chronic inflammatory airway diseases.

    abstract:BACKGROUND:Acquired somatic mutations induced by oxidative stress may contribute to the molecular pathogenesis of chronic inflammatory airway diseases. The objective of this study was to assess the intensity of oxidative DNA damage and the presence of microsatellite DNA instability (MSI), a marker of acquired somatic m...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.11-1653

    authors: Tzortzaki EG,Dimakou K,Neofytou E,Tsikritsaki K,Samara K,Avgousti M,Amargianitakis V,Gousiou A,Menikou S,Siafakas NM

    更新日期:2012-05-01 00:00:00

  • Myopathy following mechanical ventilation for acute severe asthma: the role of muscle relaxants and corticosteroids.

    abstract:BACKGROUND:Acute myopathy following mechanical ventilation for near-fatal asthma (NFA) has been described recently, and some researchers have suggested that this complication is related to the use of neuromuscular blocking agents (NMBAs) and corticosteroids (CSs). OBJECTIVES:To determine the incidence of acute myopath...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1378/chest.115.6.1627

    authors: Behbehani NA,Al-Mane F,D'yachkova Y,Paré P,FitzGerald JM

    更新日期:1999-06-01 00:00:00

  • A comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma.

    abstract::To evaluate the role of inhaled ipratropium bromide in acute asthma, a double-blind study of 384 emergency department patients compared the effect of the combination of ipratropium and albuterol with that of albuterol alone. Patients were randomized to receive nebulizer treatments with either 2.5 mg of albuterol or 2....

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.110.3.611

    authors: Karpel JP,Schacter EN,Fanta C,Levey D,Spiro P,Aldrich T,Menjoge SS,Witek TJ

    更新日期:1996-09-01 00:00:00

  • Effects of flecainide and propafenone on systolic performance in subjects with normal cardiac function.

    abstract::Flecainide and propafenone are effective in suppressing both ventricular and supraventricular tachyarrhythmias, but their efficacy is often limited by dose-related side effects. This study was performed to evaluate noninvasively the effects of intravenous flecainide and propafenone on left ventricular systolic functio...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.103.4.1068

    authors: Santinelli V,Arnese M,Oppo I,Matarazzi C,Maione S,Palma M,Giunta A

    更新日期:1993-04-01 00:00:00

  • The effect of oxygen with exercise on atrial natriuretic peptide in chronic obstructive lung disease.

    abstract::A recent study on stable, hypoxemic, COLD patients in which ANP was stimulated by LBPP demonstrated that in these individuals elevation of ANP does not exert a "normal" suppressing effect on the PRA-PA axis. Accordingly, we exercised ten comparable COLD patients, another maneuver known to stimulate ANP and to elicit c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.2.341

    authors: Mannix ET,Manfredi F,Palange P,Aronoff GR,Weinberger MH,Farber MO

    更新日期:1992-02-01 00:00:00

  • Acute Effects of Nasal CPAP in Patients With Hypertrophic Cardiomyopathy.

    abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is a common genetic disease that may cause left ventricular outflow tract (LVOT) obstruction, heart failure, and sudden death. Recent studies have shown a high prevalence of OSA among patients with HCM. Because the hemodynamics in patients with LVOT obstruction are unstable ...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.chest.2016.05.004

    authors: Nerbass FB,Salemi VMC,Pedrosa RP,Portilho NP,Ferreira-Filho JCA,Moriya HT,Antunes MO,Arteaga-Fernández E,Drager LF,Lorenzi-Filho G

    更新日期:2016-11-01 00:00:00

  • The clinical utility of flexible bronchoscopy in the evaluation of chronic cough.

    abstract:STUDY OBJECTIVES:To assess the clinical utility of flexible bronchoscopy (FB) in the evaluation of patients with chronic cough and normal or nonlocalizing chest radiographic findings. DESIGN:Retrospective chart review. SETTING:Tertiary referral center. PATIENTS:Forty-eight patients with chronic cough and no other cl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.1.268

    authors: Barnes TW,Afessa B,Swanson KL,Lim KG

    更新日期:2004-07-01 00:00:00

  • Crackles in patients with fibrosing alveolitis, bronchiectasis, COPD, and heart failure.

    abstract::We have studied the crackling lung sounds of ten patients with cryptogenic fibrosing alveolitis, ten with bronchiectasis, ten with chronic obstructive pulmonary disease, and ten with heart failure by analyzing frequency, waveform, and timing of crackles. The upper frequency limit of inspiratory sounds was higher in CF...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.5.1076

    authors: Piirilä P,Sovijärvi AR,Kaisla T,Rajala HM,Katila T

    更新日期:1991-05-01 00:00:00

  • Respiratory muscle performance in normal elderly subjects and patients with COPD.

    abstract::We studied the reproducibility of tests of RM performance in normal elderly subjects and compared their performance with that of patients with COPD. The RM strength was measured as MIP and MEP. The RM endurance was measured using a two-minute incremental threshold loading test. The max load, the average Ppk as %MIP at...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.1.90

    authors: Morrison NJ,Richardson J,Dunn L,Pardy RL

    更新日期:1989-01-01 00:00:00

  • Differences in end-of-life care in the ICU across patients cared for by medicine, surgery, neurology, and neurosurgery physicians.

    abstract:BACKGROUND:Some of the challenges in the delivery of high-quality end-of-life care in the ICU include the variability in the characteristics of patients with certain illnesses and the practice of critical care by different specialties. METHODS:We examined whether ICU attending specialty was associated with quality of ...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.13-1351

    authors: Kross EK,Engelberg RA,Downey L,Cuschieri J,Hallman MR,Longstreth WT Jr,Tirschwell DL,Curtis JR

    更新日期:2014-02-01 00:00:00

  • The role of physician-assistants in critical care units.

    abstract::We evaluated the feasibility of utilizing physician assistants as providers of primary care in a medical ICU. After a three-month period of rigorous training, two PAs were assigned to the ICU. Their performance as well as the operation of the ICU over a two-year period was evaluated and compared to two preceding years...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.1.89

    authors: Dubaybo BA,Samson MK,Carlson RW

    更新日期:1991-01-01 00:00:00

  • Occupational risk factors for sarcoidosis in African-American siblings.

    abstract:OBJECTIVES:To determine whether certain occupations and occupationally related exposures were associated with a history of sarcoidosis in African-American siblings. METHODS:We collected occupational data from 921 African Americans in 273 sibships that had been identified through a sarcoidosis case. Among the 648 sibli...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.123.5.1527

    authors: Kucera GP,Rybicki BA,Kirkey KL,Coon SW,Major ML,Maliarik MJ,Iannuzzi MC

    更新日期:2003-05-01 00:00:00

  • Fortuitous esophageal intubation.

    abstract::Esophageal malposition is a potentially disastrous complication of attempted airway intubation. We report an unusual case in which a promptly recognized esophageal intubation aided detection of a perforated gastric ulcer. After the endotracheal tube was repositioned and the ulcer was surgically repaired, our patient h...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.2.625

    authors: Dunham D,Schmidt GA

    更新日期:1993-02-01 00:00:00

  • Effect of a beta 2-agonist (broxaterol) on respiratory muscle strength and endurance in patients with COPD with irreversible airway obstruction.

    abstract::The effect of broxaterol, a new beta 2-agonist, on respiratory muscle endurance and strength was studied in a double-blind, placebo-controlled, randomized crossover clinical trial in 16 patients with chronic obstructive pulmonary disease (COPD) with irreversible airway obstruction (FEV1 = 57.1 percent of predicted). O...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.101.1.133

    authors: Nava S,Crotti P,Gurrieri G,Fracchia C,Rampulla C

    更新日期:1992-01-01 00:00:00

  • Is sick sinus syndrome an adenosine-mediated disease? Effects of intravenous aminophylline on sick sinus node function after pharmacologic autonomic blockade.

    abstract::To assess the effects of intravenous aminophylline on the sinus node, 12 patients with clinical and Holter monitor-documented sick sinus syndrome were studied (1) during the control state, (2) after pharmacologic autonomic blockade and (3) 5 min after intravenous administration of aminophylline. The effects of aminoph...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.4.887

    authors: Lai WT,Lai HM,Lin CT,Sheu SH,Hwang YS

    更新日期:1991-04-01 00:00:00

  • Linezolid vs vancomycin: analysis of two double-blind studies of patients with methicillin-resistant Staphylococcus aureus nosocomial pneumonia.

    abstract:OBJECTIVE:To assess the effect of baseline variables, including treatment, on outcome in patients with nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). DESIGN:Retrospective analysis of data from two prospective, randomized, double-blind studies. SETTING:Multinational study with 134 site...

    journal_title:Chest

    pub_type: 杂志文章

    doi:

    authors: Wunderink RG,Rello J,Cammarata SK,Croos-Dabrera RV,Kollef MH

    更新日期:2003-11-01 00:00:00

  • Intrapleural therapy for malignant pleural effusions. A randomized comparison of bleomycin and tetracycline.

    abstract::Between December 1985 and August 1988, there were 115 patients at 13 centers who were entered on a randomized comparison of tetracycline and bleomycin for treatment of malignant pleural effusions. Fifteen patients were not treated, primarily due to rapid progression of systemic cancer. Fifteen patients entered on a hi...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.100.6.1528

    authors: Ruckdeschel JC,Moores D,Lee JY,Einhorn LH,Mandelbaum I,Koeller J,Weiss GR,Losada M,Keller JH

    更新日期:1991-12-01 00:00:00

  • Acute pulmonary exacerbations of sarcoidosis.

    abstract::Exacerbations of sarcoidosis are common. In particular, exacerbations of pulmonary sarcoidosis are reported in more than one-third of patients. Despite their frequent occurrence, there is little medical evidence concerning the definition, diagnosis, and treatment of pulmonary exacerbations of sarcoidosis. In this arti...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.12-1060

    authors: Panselinas E,Judson MA

    更新日期:2012-10-01 00:00:00

  • Tuberculosis in Korea. The relationship between prior therapy and drug resistance.

    abstract::A review of 121 culture-positive cases of pulmonary tuberculosis from 1979 to 1984, including both Korean and American patients, at the major US military hospital in Korea indicated that most antituberculosis drug resistance occurred in patients with a history of previous antituberculosis therapy. The 98 patients with...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.90.2.247

    authors: Etzkorn ET,Lillis PK,McAllister CK

    更新日期:1986-08-01 00:00:00

  • Noninvasive detection of respiratory failure in the intensive care unit.

    abstract::We investigated the utility of a noninvasive respiratory inductive plethysmograph (RIP) to continuously monitor and record the breathing pattern of 44 patients who had been mechanically ventilated. Seven patients deteriorated on intermittent mandatory ventilatory rate of zero; seven deteriorated within 48 h following ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.2.254

    authors: Krieger BP,Ershowsky P

    更新日期:1988-08-01 00:00:00

  • Cholesterol in pleural effusions. A diagnostic aid.

    abstract::In this prospective study of 70 patients with pleural effusion, the underlying disease could be identified in 62 cases. By predefined criteria, 31 of these effusions were classified as transudates and 31 as exudates. Pleural fluid protein content, LDH activity and cholesterol level were measured to investigate their u...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.92.2.296

    authors: Hamm H,Brohan U,Bohmer R,Missmahl HP

    更新日期:1987-08-01 00:00:00

  • Diffuse tumor microembolism: a rare cause of a high-probability perfusion scan.

    abstract::Pulmonary tumor embolism is a rare but well-documented cause of respiratory failure in patients with cancer. This entity is probably clinically underrecognized and may represent an important cause of morbidity and mortality. A typical pattern of multiple peripheral subsegmental defects on perfusion lung scanning has b...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.111.4.1122

    authors: Moores LK,Burrell LM,Morse RW,Belgrave CH,Balingit AG

    更新日期:1997-04-01 00:00:00

  • A comprehensive review of spontaneous pneumothorax complicating sarcoma.

    abstract:BACKGROUND:Spontaneous pneumothorax (SPTX) is an uncommon phenomenon in the general population and is most commonly associated with prior bulbous emphysema, cystic parenchymal lung disease, and tuberculous lung disease. A rare cause of SPTX is malignant disease, either in the form of primary lung or pleural cancers, or...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.09-2292

    authors: Hoag JB,Sherman M,Fasihuddin Q,Lund ME

    更新日期:2010-09-01 00:00:00

  • Post-ICU mechanical ventilation at 23 long-term care hospitals: a multicenter outcomes study.

    abstract:STUDY OBJECTIVES:This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) with weaning programs, and to report treatments, complications, weaning outcome, discharge disposition, and survival in these patients. DESIGN:Observationa...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.06-1081

    authors: Scheinhorn DJ,Hassenpflug MS,Votto JJ,Chao DC,Epstein SK,Doig GS,Knight EB,Petrak RA,Ventilation Outcomes Study Group.

    更新日期:2007-01-01 00:00:00

  • A 61-Year-Old Caribbean Man With Thrush and Acute Respiratory Failure.

    abstract:CASE PRESENTATION:A 61-year-old Caribbean man presented to the ED with dyspnea that had progressed over the previous week with associated cough and high fevers. Four days prior to admission, his primary care physician noted oral thrush and obtained a chest radiograph that revealed a right middle lobe infiltrate. He was...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2017.11.001

    authors: Gong J,Melamud A,Koenig S

    更新日期:2018-07-01 00:00:00

  • A rare cause of postoperative hypotension.

    abstract::A 62-year-old woman presented with a 3-month history of abdominal distension and decreased exercise tolerance. A chest radiograph showed a probable left pleural effusion (Fig 1). A CT scan of the abdomen revealed a solid ovarian mass with omental caking and a large volume of ascites; there was also confirmation of a l...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-2245

    authors: Salinas PD,Toth LN,Manning HL

    更新日期:2015-05-01 00:00:00

  • Clinical profile of anti-PL-12 autoantibody. Cohort study and review of the literature.

    abstract:BACKGROUND:The antisynthetase syndrome consists of interstitial lung disease (ILD), arthritis, myositis, fever, mechanic's hands, and Raynaud phenomenon in the presence of an antisynthetase autoantibody, most commonly anti-Jo-1. It is believed that all the antisynthetases are associated with a similar clinical profile,...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.08-2233

    authors: Kalluri M,Sahn SA,Oddis CV,Gharib SL,Christopher-Stine L,Danoff SK,Casciola-Rosen L,Hong G,Dellaripa PF,Highland KB

    更新日期:2009-06-01 00:00:00

  • The epidemiology of lung cancer.

    abstract::Lung cancer rates and mortality have risen in epidemic proportions in the United States and other industrialized nations during the 20th century. Case-control and cohort studies performed in the 1950s and 1960s firmly established cigarette smoking as the single greatest risk factor for lung cancer. In the United State...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.103.1_supplement.20s

    authors: Samet JM

    更新日期:1993-01-01 00:00:00