Cefuroxime is a new broad-spectrum cephalosporin antibiotic with increased stability to f8-lactamases. This stability, although no absolute in all cases, has the effect of widening the antibacterial spectrum of the compound so that many organisms resistant to the established cephalosporins are susceptible to cefuroxime. It is active against gram-positive organisms, including penicillinaseproducing staphylococci, but it is less active against methicillin-resistant strains. In addition to its high activity against non-,8-lactamase-producing gram-negative bacteria, cefuroxime effectively inhibits the growth of many 1B-lactamase-producing strains, including Enterobacter, Klebsiella, and indole-positive Proteus spp. It is highly active against Neisseria gonorrhoeae, Neisseria meningitidis, and also Haemophilus influenzae, including ampicillin-resistant strains. Cefuroxime is rapidly bactericidal and induces the formation and subsequent lysis of filamentous forms over a small concentration range.

The Mini-Mental State Examination (MMSE) is a commonly used instrument for assessing mental impairment. Previous proposals for its underlying structure have focused on scores obtained from a single administration of the test. Because the MMSE is widely used in longitudinal studies, we examined the pattern of relations among the rates of chance of the items. Data were obtained from 63 subjects for 1.5 years or more. The relations among the rates of change of the MMSE items were described by a five-factor solution that accounted for 75% of the variance and comprised factors pertaining to orientation and concentration, obeying commands, learning and repetition, language, and recall. This was in contrast to the structure of the scores obtained from a single administration of the MMSE, which was best described by a two-factor solution. In order to provide a clinical validation, factor scores derived from the MMSE factors were used to predict scores on the Memory and Behavior Problems Checklist and the Brief Cognitive Rating Scale.

No abstract

The pharmacokinetic behaviour of two aminothiazolyl cephalosporins, ceftazidime (CAZ) and cefotaxime (CTX), were compared in three studies. Doses of each antibiotic were given intravenously (500 mg, n=4; 1 g, n=4) or intramuscularly (1 g, n=8) in a cross-over manner to healthy male volunteers. Antibiotic assays were performed by HPLC and microbiological assay techniques. Both antibiotics appeared to fit a two-compartment iv kinetic model with terminal half-lives of 1.7 h (CAZ) and 0.8 h (CTX). CAZ was metabolically stable whereas there was 34% conversion of CTX to desacetyl-CTX. The 24 h urinary recovery of CAZ averaged 89% but only 51% for CTX. The protein binding of CAZ was 17% and of CTX was 47%. CTX was more painful than CAZ on im injection in seven of the eight volunteers. CAZ therefore appeared to possess a number of features more favourable than those of CTX, when assessed in healthy volunteers.

Despite preclinical studies suggesting that isradipine may antagonize the abuse liability of cocaine, pretreatment with sustained-release isradipine did not reduce euphoric mood in cocaine-using volunteers. This double-blind, within-subject, crossover laboratory study determined whether maximal dose-loading with isradipine could antagonize effects of cocaine in 12 cocaine-dependent research volunteers administered intravenous cocaine doses (0, 0.325, and 0.65 mg/kg) on different days after 5 days of treatment with isradipine or placebo. Isradipine dose was 30 mg sustained release nightly plus 15 mg immediate release 2 hr before cocaine infusion. Cocaine produced dose-related increases in cocaine's subjective effects and a behavioral measure of reinforcement. Isradipine enhanced, rather than antagonized, subjective effects, indicating that isradipine does not antagonize cocaine's abuse liability in dependent research volunteers.

The purpose of this article is to describe the Community Readiness Model implemented by the San Antonio Safe Family Coalition in Bexar County, Texas, a coordinated community response to prevent intimate partner violence. The project used a participatory action process to (a) determine the city's and county's stage of readiness to prevent intimate partner violence; (b) identify differences in the city and county by dividing the area into sectors for the assessment; (c) engage the community in determining the accuracy and usefulness of the results of the assessment; (d) develop targeted strategies to move the city and county to a higher stage of readiness for prevention of intimate partner violence; and (e) evaluate the results of the project.

Since World War II, synthetic chemical pollutants have accumulated in the environment and food webs on a global basis, have damaged wildlife populations, and may pose large-scale hazards to human health. Despite the global nature of this problem, the vast majority of environmental regulations focus on preventing local risks using risk assessment of individual compounds, discharge permits, and control and disposal technologies. The current approach has failed to prevent global contamination and environmental damage because it underestimates the scale, complexity, and diversity of the hazards of chemical pollution. Fundamental shifts in the mode of chemical assessment and policy are required; a new framework should focus on chemical classes rather than individual substances, convert industrial processes to prevent the production and use of persistent and/or bioaccumulative substances, and shift the default state of pollution policy in the face of uncertainty from permission to restriction.

No abstract