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The anterior approach for knee arthrography is technically successful and well tolerated, particularly when an anterolateral route is used.

The antibacterial activity of XRP2868, a new oral streptogramin composed of a combination of RPR132552 (streptogramin A) and RPR202868 (streptogramin B), was evaluated against a collection of clinical grampositive isolates with characterized phenotypes and genotypes of streptogramin resistance. The effects of genes for resistance to streptogramin A or B on the activity of XRP2868 and its components were also tested by cloning these genes individually or in various combinations in gram-positive recipient strains susceptible to quinupristin-dalfopristin. The species tested included Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus faecalis, Enterococcus faecium, Streptococcus pneumoniae, and other species of streptococci. XRP2868 was generally fourfold more potent than quinupristin-dalfopristin against S. aureus, E. faecium, and streptococci and had activity against E. faecalis (MICs ‫؍‬ 0.25 to 1 g/ml). XRP2868 appeared to be affected by the same mechanisms of resistance as those to quinupristin-dalfopristin. Nevertheless, the strong activity of factor A of the oral streptogramin enabled the combination to be very potent against streptograminsusceptible staphylococci, streptococci, and E. faecium (MICs ‫؍‬ 0.03 to 0.25 g/ml) and to retain low MICs against the strains harboring a mechanism of resistance to factor A or factor B of the streptogramin. However, the combination of mechanisms of resistance to factors A and B caused an increase in the MICs of XRP2868, which reached 1 to 4 g/ml. As with the other streptogramins, there was a reduction in the bactericidal effect of XRPR2868 when the staphylococcal strains acquired a constitutively expressed erm gene.Multidrug resistance in gram-positive cocci has increased at an alarming rate in clinical settings worldwide, and overcoming bacterial resistance has become more important than ever. Several new drugs have been proposed as alternatives for the treatment of severe infections caused by multiply resistant gram-positive organisms, i.e., linezolid, daptomycin, tigecycline, and quinupristin-dalfopristin. Quinupristin-dalfopristin, an injectable streptogramin, was among the first to be developed internationally (3). Streptogramins have the advantage of bactericidal activity against pneumococci and staphylococci, provided that they are susceptible to clindamycin (11). However, quinupristin-dalfopristin can be administered only parenterally; and except for pristinamycin, which is available in France, oral streptogramins are not available (5). In addition, the administration of quinupristin-dalfopristin requires the presence of a deep-vein catheter because of venous toxicity (21). Therefore, the value of the international development of a new oral streptogramin that can be used as a replacement or as the treatment of first choice has become obvious.XPR2868 is a new investigational oral streptogramin that is composed of a mixture of 70% RPR132552 (streptogramin group A) and 30% RPR202868 (streptogramin group B) (18). The new compound was shown to inhibi...

Osteoid osteoma is a painful benign bone tumor. The curative treatment of this tumor consists of complete surgical or percutaneous excision of the nidus with immediate and dramatic relief of symptoms. Interstitial laser photocoagulation (ILP) is a low-invasive percutaneous technique of thermal destruction (coagulation) of deep-seated tumors elsewhere in the body, using low-power laser energy. The aim of ILP is the local destruction of osteoid osteoma without bone weakening. Twenty-two patients with osteoid osteoma were treated with percutaneous ILP of the nidus under computed tomography guidance. The laser energy was provided by a high-power semiconductor diode laser (805 nm) with a 400-&mgr;m optical fiber. Complete pain relief was obtained in 21 patients. Percutaneous ILP of osteoid osteoma seems to be a promising, simple, precise, and minimally invasive technique as an alternative to traditional surgical and percutaneous ablations.