In vitro Efficacy of Ureteral Catheters Impregnated with Ciprofloxacin, N-acetylcysteine and their Combinations on Microbial Adherence

Background Ureteral catheters are valuable indispensable devices may readily acquire biofilms on the inner or outer surfaces. This study evaluated the efficacies of ureteral catheters impregnated with ciprofloxacin, N-acetylcysteine each alone and in combination on microbial adherence. Methods Antimicrobial durability of ureteral catheters coated, through instant dip method, with ciprofloxacin were determined using modified Kirby-Bauer method. Ciprofloxacin-coated catheters showed zones of inhibition ranged from 15 to 45 mm in diameter (baseline) against nine clinical strains recently isolated from patients undergoing ureteral stent removal. Segments coated with ciprofloxacin, N-acetylcysteine each alone and in combination, through instant dip method, were incubated with the tested microorganisms, washed, sonicated, cultured and the number of viable cells were determined. Results Ciprofloxacin-coated catheters soaked in urine and incubated at 37 °C, maintained antimicrobial activities and produce zones of inhibition that measured 2–10 mm for at least 8 weeks. Effect of ciprofloxacin and N-acetylcysteine coated catheters on microbial adherence were found to be dose dependent. Catheters impregnated with ciprofloxacin/N-acetylcysteine showed the highest inhibitory effect on microbial adherence when compared with controls (85.5%–100%). Conclusion Catheters impregnated with ciprofloxacin, using instant dip method, were shown to have broad spectrum, prolonged antimicrobial durability and high efficacy. On the other hand, Catheters impregnated with ciprofloxacin/NAC showed the highest inhibitory effect on microbial adherence to stent surfaces.

Estimation of Accurate and New Method for Hemodialysis Dose Calculation

Background The Kt/V value demonstrates the dose of hemodialysis (HD). However, because of several existing methods for calculating delivered dialysis dose, Kt/V values can, in fact, be different for the same set of pre-/post-dialysis blood urea concentrations. Methods In the study presented here, another formula was derived for calculating Kt/V from the pre- and post-dialysis BUN. We prospectively compared the Kt/V values obtained using this new formula and the Kt/V values obtained via the other existing formulae to see whether reliance on the latter approach was likely to lead to errors in over- or underprescribing dialysis regimens. Data were processed on 268 dialysis patients. Results The estimated Kt/V (Kt/Vest) values were statistically different (p < 0.05) from the calculated Kt/V values from other models, except for those Kt/V values calculated according to the lowrie (P = 0.112), Keshaviah (P = 0.069), Daugirdas First Generation (P = 0.059), Basile (P = 0.102), Ijely (P = 0.286) and Daugirdas Second Generation (P = 0.709). The best correlations were seen with the Daugirdas second generation formula (R = 0.958 and R2 = 0.919). Conclusion Since the best correlations were seen between Kt/Vest and the Daugirdas second generation Kt/V we can demonstrate that these two models are more accurate than the other models.

Results of a Randomized Clinical Trial of the Action of Several Doses of Lycopene in Localized Prostate Cancer: Administration Prior to Radical Prostatectomy

Purpose The purpose of this Phase II randomized-controlled trial was to evaluate the safety and effect of administering several doses of lycopene to men with clinically localized prostate cancer, on intermediate endpoint biomarkers implicated in prostate carcinogenesis. Methods Forty-five eligible men with clinically localized prostate cancer were supplemented with 15, 30 or 45 mg of lycopene or no supplement from biopsy to prostatectomy. Compliance to study agent, toxicity, changes in plasma lycopene, serum steroid hormones, PSA and tissue Ki-67 were analyzed from baseline to completion of intervention. Results Forty-two of forty-five five subjects completed the intervention for approximately 30 days from the time of biopsy until prostatectomy. Plasma lycopene increased from baseline to post treatment in all treatment groups with greatest increase observed in the 45 mg lycopene-supplemented arm compared to the control arm without producing any toxicity. Overall, subjects with prostate cancer had lower baseline levels of plasma lycopene similar to those observed in previous studies in men with prostate cancer. Serum free testosterone decreased with 30 mg lycopene supplementation and total estradiol increased significantly with 30 mg and 45 mg supplementation from baseline to end of treatment, with no significant increases in serum PSA or tissue Ki-67. These changes were not significant compared to the control arm for this sample size and duration of intervention. Conclusions Although antioxidant properties of lycopene have been hypothesized to be primarily responsible for its beneficial effects, our study suggests that other mechanisms mediated by steroid hormones may also be involved.