Abstract:
:Trovafloxacin, a new fluoronaphthyridone derivative related to fluoroquinolone antimicrobial drugs, has demonstrated the following characteristics: significant gram-positive and gram-negative activity; significant activity against anaerobes and atypical respiratory pathogens; approximately 11-hour elimination half-life, permitting once-daily administration; and good tissue penetration. Because <10% of an orally administered dose is recovered in urine as unchanged drug, the predominant route of trovafloxacin elimination appears to be nonrenal. The two studies described in this review examined the metabolism and excretion of trovafloxacin and compared the time course and concentrations of trovafloxacin and its metabolites in bile to those in serum. In the first study, four healthy male volunteers received a single, oral 200-mg dose of radiolabeled trovafloxacin. In the second study, three patients with indwelling nasobiliary tubes received a single 200-mg dose of trovafloxacin. Samples of blood, urine, bile, and feces were collected. Trovafloxacin in urine and serum was analyzed by high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection and in bile by HPLC-mass spectroscopy (MS). Levels of the N-acetyl metabolite in bile were determined by HPLC/UV/MS. Metabolites in serum, urine, and feces were determined by reverse-phase HPLC/MS, and radioactivity in these samples was assayed by liquid scintillation counting. In the first study, 63.3% and 23.1% of total radioactivity were recovered in feces and urine, respectively, with most of the radioactivity in urine in the form of the ester glucuronide metabolite (12.8%) and unchanged trovafloxacin (5.9%). Unchanged drug, the N-acetyl metabolite, and the N-sulfate of trovafloxacin accounted for 43.2%, 9.2%, and 3.9%, respectively, of the radioactivity in feces. In the second study, biliary trovafloxacin concentrations were highest between 1.5 and 10 hours postdose, and the maximum concentrations ranged from 18.9 to 37.9 microg/mL. The mean bile:serum ratio of trovafloxacin was 14.9, and the biliary concentration of parent drug was higher than that of its N-acetyl metabolite. In both studies, trovafloxacin was well tolerated, with no discontinuations due to adverse events. The pharmacokinetic profile of trovafloxacin in serum was consistent in healthy subjects and in individuals who had undergone recent hepatobiliary surgery. Trovafloxacin is metabolized primarily by the liver, through phase II metabolism (glucuronidation 13.2%, N-acetylation 10.4%, and N-sulfoconjugation 4.1%); minimal oxidative metabolism was detected. Renal elimination accounted for <10% of the administered dose. The high bile to serum ratio and higher trovafloxacin concentrations relative to metabolite concentrations are consistent with nonrenal elimination. These pharmacokinetic and pharmacodynamic results, together with a broad antimicrobial spectrum, long 11-hour elimination half-life, and low drug-interaction potential, suggest that trovafloxacin may be particularly appropriate for use in the surgical setting.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Vincent J,Teng R,Dalvie DK,Friedman HLdoi
10.1016/s0002-9610(98)00213-xsubject
Has Abstractpub_date
1998-12-01 00:00:00pages
8S-13Sissue
6A Suppleissn
0002-9610issn
1879-1883pii
S0002-9610(98)00213-Xjournal_volume
176pub_type
杂志文章abstract:BACKGROUND:Portal hypertension is frequently associated with secondary hypersplenism, two common clinical manifestations of which are leukopenia and thrombocytopenia. Surgical portosystemic shunts alleviate portal hypertension but their effect on hypersplenism remains unpredictable. Transjugular intrahepatic portosyste...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00006-8
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Clinically evident Anastomotic Leakage (AL) remains one of the most feared complications after colorectal resections with primary anastomosis. The primary aim of this systematic review and meta-analysis was to determine whether Prophylactic Drainage (PD) after colorectal anastomoses confers any advantage in ...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.amjsurg.2019.05.006
更新日期:2020-01-01 00:00:00
abstract::Static and dynamic forces exerted on 6-0 polypropylene suture material after carotid arteriotomy were measured in 22 adult mongrel dogs. Force was measured in 11 normotensive animals (Group I) before and 6 weeks after carotid artery repair. Force was measured in the remaining animals during normotension and induced hy...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90618-1
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS. METHODS:We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::The relative merits of the anterior and posterior approaches to the adrenal gland were assessed in a series of 103 patients with bilateral cortical hyperplasia or unilateral cortical adenoma (less than 25 g). In none of the patients was additional concomitant surgery planned. Sixty-four patients were operated on throu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90010-1
更新日期:1982-09-01 00:00:00
abstract:BACKGROUND:Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics. MATERIAL AND METHODS:Fourteen mongrel dogs were ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00140-7
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate if serum Tg mRNA assay predicts recurrence in patients undergoing thyroidectomy for cancer. METHODS:Sixty-four consecutive patients undergoing surgery between April 1997 and July 1999 were studied. One year after surgery, blood samples were taken for serum thyrog...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.09.047
更新日期:2008-09-01 00:00:00
abstract::The results of aggressive surgical treatment of primary lip cancer and advanced and recurrent carcinoma of the lip are illustrated and discussed. Early detection of involved lymph nodes before capsular penetration occurs and careful and complete dissection of the submental and submandibular regions are advocated as po...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90326-3
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND:Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared. METHODS:Patients age ≥14, needing operations for acute traumatic vascu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.11.011
更新日期:2016-03-01 00:00:00
abstract::Obesity is a serious health problem in the United States today, and surgical treatment is recognized as long-term effective therapy. Minimally invasive techniques are becoming the "gold standard" approach to the treatment of disease, and robotic surgery has the potential to advance the use and development of minimally...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.08.027
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. METHODS:A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 20...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.03.012
更新日期:2017-05-01 00:00:00
abstract::We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80618-x
更新日期:1990-01-01 00:00:00
abstract::Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular compli...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90119-8
更新日期:1994-04-01 00:00:00
abstract::Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and gallium-67 scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about wh...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90195-7
更新日期:1982-04-01 00:00:00
abstract::Fourteen infants with intestinal stenosis as a late sequela of necrotizing enterocolitis were treated at Texas Children's and Ben Taub General Hospitals from 1972 to 1979. Barium enema studies are the keystone in making the diagnosis and should be performed in any infant with abdominal distention or poor feeding after...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90320-2
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:Autotransfusable shed blood has been poorly characterized in trauma and may have similarities to whole blood with additional benefits. METHODS:This was a prospective descriptive study of adult patients from whom ≥50 mL of blood was drained within the first 4 hours after chest tube placement. Pleural and ven...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.043
更新日期:2011-12-01 00:00:00
abstract::The hospital and office records of 86 patients who underwent proctectomy for cancer of inflammatory bowel disease with primary closure of the perineal wound were reviewed. Almost one fourth of all patients suffered a significant perineal wound complication, the majority of which were infections. The incidence of posto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90187-3
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:The treatment for a contralateral breast cancer (CBC) presents a growing dilemma given the expanding number of long-term survivors. We hypothesize that there will be specific surgical treatment trends with demographic differences between the treatment groups. METHODS:The Surveillance, Epidemiology, and End ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.05.010
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Standard two-dimensional (2D) specimen radiography may guide intraoperative re-excision of margins in patients undergoing breast conserving surgery. We sought to determine the impact of three-dimensional (3D) specimen imaging in further reducing positive margin rates. METHODS:A prospective study of 100 pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.018
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Numerous protocols for laparoscopic skills training using simulator-based laboratories have proven effective. However, little is known about the availability and uniformity of such facilities. The purpose of this study was to evaluate the prevalence, utilization, and costs of skills laboratories currently in...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2005.05.048
更新日期:2006-01-01 00:00:00
abstract::Over the last decade, significant technological advancements have occurred in cardiac surgery. One such breakthrough has been the use of robotic telemanipulation systems, which allow the surgeon to perform cardiac surgery through a minimally invasive approach. As a result, surgery for atrial fibrillation and resynchro...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2004.08.001
更新日期:2004-10-01 00:00:00
abstract::Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90571-2
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:Hemoperfusion with PMX-F (polymyxin B covalently immobilized on fibers) has been reported to be safe and effective for patients with septic shock. However, the molecular mechanism of this usefulness is not yet clear. The purpose of this study was to evaluate whether the expression of CD14, human leukocyte an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.067
更新日期:2004-08-01 00:00:00
abstract::Early diagnosis of esophageal perforation is critical. The importance of performing sufficient surgery at the first procedure whenever possible is emphasized. If early primary closure cannot be achieved, then the initial therapeutic method of choice is resection or diversion followed by reconstruction. Drainage of the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90379-7
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Clostridium difficile infection (CDI) is a common cause of healthcare associated infections contributing to morbidity and mortality. Our objective was to evaluate the impact of the implementation of a CDI bundle along with probiotic utilization. METHODS:A retrospective review of trauma admissions from 2008 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.005
更新日期:2018-05-01 00:00:00
abstract::Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90142-3
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGB) produces durable and clinically significant weight loss. We aim to characterize the trajectory of weight loss, and demonstrate the predictive ability of three-month performance on final weight loss. METHODS:Retrospective analysis of 1097 consecutive LRYGB patien...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.024
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.04.020
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to describe the incidence and clinical/pathologic characteristics of papillary thyroid microcarcinoma (PMC) in a community hospital setting and to evaluate the frequency and characteristics of these lesions when unsuspected preoperatively. METHODS:A total of 723 patients underw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.12.008
更新日期:2012-02-01 00:00:00
abstract::Breast symptoms of pain, tenderness, and engorgement correlate with objective findings of nodularity on physical examination. Like all other factors for breast disease, they are not a single determinant of diagnosis, as shown by the 3 X 3 contingency table, but they are a useful addition to our understanding. From the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90135-7
更新日期:1985-08-01 00:00:00