Ceftazidime: pharmacokinetics in young volunteers versus elderly patients and therapeutic efficacy with complicated urinary tract infections

Thirty-six urological patients (21 male, 15 female) aged 21 to 83 years with complicated and/or hospital-acquired urinary tract infections due to sensitive bacteria were treated with ceftazidime intravenously with a daily dose of 2 g bd over 5 to 17 days. Twenty-seven patients were followed for 1 to 4 weeks after therapy. Cure was observed in 41%, reinfection in 33% and relapse in 26% of the patients. Eradication of the original pathogen occurred in 74%. Five patients showed minor side effects: diarrhoea (2), nausea (1), rash (1), headache (1). No signs of renal, hepatic or haematological toxicity were observed. A pharmacokinetic study was performed in 13 elderly patients aged 63 to 83 years on day 1 of treatment and in 6 volunteers aged 24 to 32 years following administration of 2 g of ceftazidime as short intravenous infusion. The mean serum half life in 12 patients 2.9 h significantly higher than in volunteers (1.75 h). Serum concentrations in patients on day 7 of treatment, however, showed no accumulation when treated with a dosage of 2 g bd

High-performance liquid chromatography analysis of mezlocillin, piperacillin, their degradation products, and of ioxitalamic acid in plasma and urine of healthy volunteers

In plasma and urine of 10 healthy volunteers after intravenous administration of 4 g mezlocillin and piperacillin, respectively, the parent compounds as well as degradation products were assayed by high-performance liquid chromatography. Ioxitalamic acid, a renal contrast medium, was administered simultaneously, in order to measure the glomerular filtration rate, and to control the collection of 24-h urine. As metabolite of mezlocillin the corresponding penicilloic acid only was found, whereas in the case of piperacillin a further degradation product was observed. Half of the doses given was recovered in the urine as unchanged drugs, and in addition 5-10% as metabolites. No differences were found in the pharmacokinetic behaviour of both antibiotics

Pharmacokinetics, in-vitro activity, therapeutic efficacy and clinical safety of aztreonam vs. cefotaxime in the treatment of complicated urinary tract infections

The minimal inhibitory concentrations (MICs) of aztreonam and cefotaxime were determined against 400 isolates from urological in-patients with complicated and/or hospital acquired urinary tract infections (UTI). Against the Gram-negative rods the activities of both antibiotics were comparable except for higher activity of aztreonam against Pseudomonas aeruginosa. The pharmacokinetic study in nine elderly patients showed a prolonged plasma half life of aztreonam (2.7 h) as compared to younger volunteers (1.6-1.9 h). In a prospective randomized study 39 urological patients with complicated and/or hospital acquired UTI were treated with 1 g aztreonam or cefotaxime iv twice daily for 4 to 15 days. Cure was obtained in 5 out of 18 patients in the aztreonam and 7 out of 20 patients in the cefotaxime group. There were 3 superinfections, 7 relapses and 3 reinfections in the aztreonam group and 1 failure, 1 superinfection, 6 relapses and 5 reinfections in the cefotaxime group. There was no significant difference in therapeutic efficacy between the two antibiotics. Both antibiotics were tolerated well and seem to be equally effective in the treatment of complicated UTI caused by sensitive organisms

Strukturelle Charakterisierung eines unbekannten Metaboliten von Ciprofloxacin [Structural characterization of an unknown metabolite of ciprofloxacin]

The chemical structure of an unknown metabolite of ciprofloxacin (CAS 85721-33-1) is characterized by means of reversed phase ion pair liquid chromatography, absorption and fluorescence spectroscopy, partition coefficients as well as chemical and enzymatic hydrolytic degradation. A chemical structure of the unknown metabolite is proposed: N-formyl-desethylen-ciprofloxacin. It can be formed as an intermediate in the oxidative degradation of ciprofloxacin via oxociprofloxacin to desethylen-ciprofloxacin, or it may be formed by conjugation of desethylen-ciprofloxacin with formic acid. The amounts found in plasma and urine of patients were in the range of desethylen-ciprofloxacin, i.e. about 1% of the parent compound

Essays on Private Equity and Value Creation Levers in European Buyout Transactions

Leveraged buyouts constitute a key pillar of the success private equity funds experience in the domain of alternative investments. This dissertation comprises of three essays, which are based on the empirical analysis of novel data sets. The three essays address the topic of private equity and value creation in European buyouts, which connect to an updated view on the buyout dynamics in the European low interest environment after the global financial crisis of 2008. The first essay (Grobecker and Hartmann-Wendels, 2020, “The Architecture of Success: Value Creation at Transaction Level in European Private Equity Buyouts”) explores the sources of value creation and examines governance, operational and financial effects at transaction level. The second essay (Grobecker and Hartmann-Wendels, 2020, “The Management Narrative in European Private Equity Transactions – an Empirical View on the Accuracy of Buyout Forecasts”) focuses on the accuracy of financial forecasts presented by the target company’s management prior to the buyout and investigates potential drivers of predictive errors. The third essay (Grobecker, 2021, “Negotiation Power of Private Equity Funds – Evidence from Sale and Purchase Agreements in European Buyouts”) analyses the contractual terms governing the buyout acquisition from a risk allocation perspective. Based on a scoring framework, the third essay relates the contractually agreed terms to determinants affecting the negotiation power of private equity funds in buyout settings

Bone Damage during Dental Implant Insertion: A Pilot Study Combining Strain Gauge and Histologic Analysis

Besides alveolar bone quality, the drilling protocol applied in conjunction with the design of an implant are the major determinants of primary implant stability. Surgical trauma and bone compression resulting from implant insertion may constitute one cause for marginal bone resorption. Inserting two current bone-level implant designs (Astra; Straumann; n = 5) in bovine ribs, primary stability, strain development on the buccal bone plate and histologic signs of bone damage were recorded. Besides comparing the implant designs (Welch t-tests), all measurement parameters were checked for potential correlations (Pearson product moment correlation coefficients) with the level of significance set at α = 0.05. Considerable numbers of crack formation and plastic deformation of bone were observed after implant insertion. Straumann implants showed slightly greater values for insertion torque (p = 0.772), strain development (p = 0.893) and implant stability (p = 0.642). Significantly greater bone to implant contact (cortical p = 0.014; trabecular p = 0.016) was observed in Straumann implants, while Astra implants caused a significantly greater number of microcracks in cortical bone (p = 0.020). In Straumann implants, insertion torque correlated with bone to implant contact in the cortical area (p = 0.029) and the number of macrocracks in trabecular bone correlated with bone to implant contact (p = 0.029). In Astra implants, insertion torque and bone to implant contact in the trabecular area correlated (p = 0.007) as well as the number of macrocracks in trabecular bone and implant stability (p = 0.016). Additionally, in the area of cortical bone, the number of macrocracks correlated with bone to implant contact (p = 0.019). Implant placement results in bone damage of varying magnitude, which is governed by the drill protocol, implant macrodesign and bone quality

Does intraoperative bone density testing correlate with parameters of primary implant stability? A pilot study in minipigs

Objectives: Bone density, surgical protocol, and implant design are the major deter-minants of primary stability. The goal of this animal trial was to investigate potentialcorrelations of intraoperative bone density testing with clinical and histologic param-eters of primary implant stability.Material and methods: Following extractions of all mandibular premolars and subse-quent healing, four implants each were placed in a total of four minipigs. Bone den-sity was determined by applying intraoperative compressive tests using a devicenamed BoneProbe whereas measurements of implant insertion torque and resonancefrequency analysis were used for evaluating implant stability. Bone mineral density(BMD) and bone to implant contact were quantified after harvesting mandibularblock sections. Spearman rank correlation tests were performed for evaluating corre-lations (α = .05).Results: Due to variation in clinical measurements, only weak correlations could beidentified. A positive correlation was found between the parameters bone to implantcontact and BMD (Spearman's rho .53; p=.05) whereas an inverse correlation wasobserved between BMD and implant stability (Spearman's rho −.61; p=.03). BothBoneProbe measurements in the cortical and trabecular area positively correlatedwith implant insertion torque (Spearman's rho 0.60; p=.02). A slightly stronger corre-lation was observed between the average of both BoneProbe measurements andimplant insertion torque (Spearman's rho.66; p=.01).Conclusions: While establishing exact relationships among parameters of implant sta-bility and the measurement techniques applied would require greater sample size,intraoperative compressive testing of bone might, despite the weak correlations seenhere, be a useful tool for predicting primary implant stability

Preclinical Performance of a Novel Dental Implant Design Reducing Mechanical Stress in Cortical Bone

This animal study compared the healing performance of a novel implant design characterized by a shift in thread geometry and core diameter with two different surfaces with that of an apically tapered implant. Test Bioactive (n = 9), Test Porous (n = 7) and Control (n = 8) implants were placed in the mandibles of minipigs. Following healing, bone samples were harvested for determining bone-to-implant contact (BIC) and marginal bone loss (MBL). Comparative statistics were based on Levene’s test, Shapiro–Wilk tests, the Kruskal–Wallis test and Wilcoxon tests with Holm correction (α = 0.05). The mean undersizing of the osteotomy was 0.15 mm for Control, while in the test groups 0.33 mm and 0.34 mm were calculated. Insertion torques ranged from 61.5 Ncm (Control) to 76.1 Ncm (Test Bioactive). Maximum BIC was seen in Test Porous with 55.83%, while Test Bioactive showed only 48.11%. MBL was 4.1 mm in Test Bioactive, while Test Porous and Control exhibited 2.8 mm. No significant differences between the implant groups were observed (p > 0.05). Despite greater undersizing, the novel implant type performed comparably to the established Control implants. The rougher surface of the bioactive implants increased the insertion torque and led to more MBL

Biomechanical Rationale for a Novel Implant Design Reducing Stress on Buccal Bone

Modern implant designs should allow for adequate primary stability but limit mechanical stress on buccal bone in order to prevent initial marginal bone loss. A dental implant characterized by a shift in core diameter and thread geometry was evaluated. Polyurethane foam was used as bone surrogate material and implant placement was performed measuring insertion torque and strain development on buccal bone using strain gauges as well as primary stability by using damping capacity assessments. An existing tapered bone-level implant was used as a control while the novel experimental implant described above (n = 10) was used in the test group. Statistical analysis was based on t-tests (α = 0.05). Both the maximum insertion torque (p = 0.0016) and maximum strain development in buccal bone (p = 0.1069) were greater in control implants as compared to the novel implant design. Moreover, in the control group, these were reached at a significantly later timepoint of the insertion process, i.e., when the implant was almost fully seated (maximum insertion torque p = 0.0001, maximum strain development p < 0.00001). The final insertion torque (p < 0.00001) and final strain development (p = 0.0137) were significantly lower in the novel implant design while the primary stability of both implant types did not differ significantly (p = 0.219). The novel implant design allowed for a greater undersizing of osteotomies while not mechanically overstressing buccal bone. Comparable primary stability was obtained from trabecular bone instead of compressing cortical bone as occurs in conventional, existing tapered implant designs

Pilot study on the applicability of boron-doped diamond electrodes for tooth whitening

Objectives While various approaches are available for tooth whitening, the basic concept employs the use of peroxides in the form of gels, which are applied to tooth surfaces. Previous studies have shown that reactive oxygen species acting as potent disinfectants can be produced using boron-doped diamond (BDD) electrodes for the electrolysis of water. With these electrodes being applicable, for example, for endodontic treatment, it was the goal of this pilot study to use such electrodes for tooth whitening. Material and Methods Two groups (n = 10) of intact clinical crowns were obtained by horizontally cutting off roots of extracted human teeth. The crowns were either bleached by applying a commercially available agent based on 40% hydrogen peroxide or were immersed in saline undergoing electrolysis with BDD electrodes. Whitening of specimens was judged on standardized photographs by examiners with three different levels of experience. Statistical analysis was based on Gwet's AC2 coefficient with quadratic weights, Shapiro–Wilk tests, and two-way analysis of variance of aligned rank transformed data (level of significance set at α = .05). Results Levels of reliability ranging from fair to substantial were recorded for single persons while the level of reliability ranged between fair and moderate for groups of raters. The level of experience had no significant effect on the ratings (p = .2500). The bleaching method had a significant effect on ratings (p = .0005) with BDD electrodes showing less effect. Conclusions Bleaching by applying BDD electrodes was possible, but was not as effective as the use of commercially available in-office whitening gel. A potential explanation may be seen in different concentrations of reactive oxygen species