Lopinavir, an antiretroviral drug against human immunodeficiency virus (HIV), was administered through various routes to an HIV-infected patient with duodenal malignant lymphoma. Antiretroviral drugs were first administered through a jejunal tube, and then through bypass route between the stomach and jejunum that was 20 cm distal from the ligament of Treitz after surgery. Oral administration through the bypass achieved sufficient serum concentrations of lopinavir, whereas administration through the jejunal tube did not.
2 Cavalcanti AL, Bagnoli VR, Fonseca AM, et al. Effect of sildenafil on clitoral blood flow and sexual response in postmenopausal women with orgasmic dysfunction. Int J Gynaecol Obstet 2008;102:115-9 3 Laan E, van Driel EM, van Lunsen RH. Genital responsiveness in healthy women with and without sexual arousal disorder. J Sex Med 2008;5:1424-35 4 Suschinsky KD, Lalumiere ML, Chivers ML. Sex differences in patterns of genital sexual arousal: measurement artefacts or true phenomena? Arch Sex Behav 2008; (epub ahead of print) 5 Chivers ML, Rieger G, Latty E, Bailey JM. A sex difference in the specificity of sexual arousal. Psychol Sci 2004;15:736 -44 6 Rellini AH, McCall KM, Randall PK, Meston CM. The relationship between women's subjective and physiological sexual arousal. Psychophysiology 2005;42:116-24
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Bacillus cereus as a pathogen and retention of medical devices are risk factors for Bacillus bacteremiaBackground: Bacillus species are ubiquitous in environment. Positivity of blood cultures with these bacteria usually are recognized as contamination, although several cases have been reported as definite bacteremia. The aim of this study is to evaluate the incidence, risk factors, antibiotic susceptibilities and prognosis in Bacillus bacteremia.Methods: From April 2003 to March 2008, all the adult inpatients from whose blood culture was isolated Bacillus species in the University of Tokyo Hospital were enrolled. Clinical characteristics were retrospectively reviewed from medical records. Definite bacteremia was defined as the following criteria; 1) two or more positive blood cultures collected at the same day, 2) one positive blood culture and positive cultures sampled from other sites, or 3) positive blood cultures in continuous days. Other cases of positive blood cultures with Bacillus species were defined as indefinite cases. Microbiological data including antibiotic susceptibilities were also collected. Primary endpoint was defined as 30-day mortality.Results: In all the 3094 cases of positive blood cultures in the study period, 94 cases (3.0%) were due to Bacillus species. Of the 94 positive blood culture cases with Bacillus species, definite bacteremia were 22 cases (23.4%) and indefinite cases were 72 cases (76.6%). As for clinical characteristics and microbiological data, only two significant factors were higher in definite bacteremia cases than in indefinite cases; retention of medical device other than central venous catheters and Bacillus cereus as a pathogen (45.5% vs. 13.2%; p = 0.001, 36.4% vs. 12.5%; p = 0.010, respectively). In multivariate analysis, these factors were significant for Bacillus bacteremia. (Odds ratio (OR) 3.78; Confidence Interval (CI) 1. OR 4.42; respectively). No statistical differences were shown between the two groups in antibiotic susceptibilities, the rate of the initial use of susceptible antibiotics and 30days mortality.Conclusion: In cases of positive blood cultures with Bacillus species, the rate of definite bacteremia was 23.4%. Bacillus cereus as a pathogen and retention of medical devices were two significant risk factors for Bacillus bacteremia. Antibiotic susceptibilities and prognosis were similar between definite bacteremia cases and indefinite cases.
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