Search

With the current arsenal of antibiotics increasingly becoming ineffective against bacteria, there is an increasing interest in the possibility of using previously approved non-antibiotic drugs as antimicrobials. Statins have recently been investigated for their antimicrobial activity and their ability to potentially synergize with current treatment options. Atorvastatin had been shown previously to be the most promising candidate for effectivity against Acinetobacter baumannii ATCC17978. In this study, we tested atorvastatin for its activity against an extensively drug-resistant (XDR) strain A. baumannii AB030. However, our data show that atorvastatin has no effect A. baumannii AB030. Intriguingly, atorvastatin was also ineffective against our laboratory’s A. baumannii ATCC17978. This lack of atorvastatin activity against A. baumannii ATCC17978 cannot be attributed to RND efflux pumps as a strain deficient in the three most clinically relevant RND efflux systems in A. baumannii showed no change in susceptibility compared to its parent strain ATCC17978. Further, atorvastatin failed to potentiate the activity of tobramycin and ciprofloxacin. While it is not clear to us why atorvastatin is not active against A. baumannii ATCC17978 used in our study, our study shows that evaluation of compounds for their antibacterial activity should involve multiple strains to account for strain-to-strain variation.

Acinetobacter baumannii AB042, a triclosan-resistant mutant strain, was examined for modulated gene expression using whole-genome sequencing, transcriptomics and proteomics in order to understand the mechanism of triclosan resistance as well as its impact on A. baumannii. Data revealed modulated expression of the fatty acid metabolism pathway, co-factors known to play a role in the synthesis of fatty acids, as well as several transcriptional regulators. The membrane composition of the mutant revealed a decrease in C18 with a corresponding increase in C16 fatty acids compared with the parent strain A. baumannii ATCC 17978. These data indicate that A. baumannii responds to triclosan by altering the expression of genes involved in fatty acid metabolism, antibiotic resistance and amino acid metabolism.

Summary Background While esthetic outcomes in hair restoration surgery (HRS) have improved markedly since the advent of follicular unit transplantation (FUT), various undesirable sequelae persist. We investigated the technical and demographic variables that may contribute to the frequency of postoperative hyperesthesia. Methods A multicenter retrospective chart review involving 552 patients undergoing HRS from 1999 to 2009. Results A total of 19 patients (3.4%) reported postoperative hyperesthesia in either the donor or recipient area of their scalp. Although many trends emerged, one variable significantly influenced the rate of this neurosensory symptom. While no patient who had all previous and current HRS sessions performed entirely within the same investigated surgical practice (n = 42) experienced postoperative hyperesthesia, 14% of our patients who underwent prior HRS by a physician outside of the investigated surgical group (n = 35) developed this complication (P = 0.0404). The amount of intraoperative electrocautery to maintain hemostasis (P = 0.0897), degree of tension upon donor wound closure (P = 0.3044), and extent of donor wound edge undermining (P = 0.4420) influenced the frequency of this sequela to a lesser degree. Conclusion These results suggest that physicians planning repair sessions on patients who have undergone prior HRS by a physician at a different surgical center should include the specific caveat of increased incidences of postoperative hyperesthesia in their preoperative consultation.

Objective: To evaluate the results of two operations, aortic valve-sparing and aortic root replacement, in patients with aortic root aneurysm and the Marfan syndrome. Methods: A retrospective review of 78 consecutive patients with aortic root aneurysm and the Marfan syndrome according to the Gent criteria indicated that 42 patients with normal aortic cusps had an aortic valve-sparing operation, and 36 patients had aortic root replacement (mechanical valve in 25 patients and biological valve in 11). The mean age was similar in both groups, but patients who had aortic root replacement had larger aneurysms, higher grade aortic insufficiency, worse left ventricular function and more cardiac co-morbidity than patients who had aortic valve-sparing operations. The mean follow-up was 41 ^ 35 months for patients who had aortic valve-sparing, and 65 ^ 50 months for those who had aortic root replacement. Results: Kaplan‐Meyer estimates of survival at 5 years was 100% for patients who had aortic valve-sparing, and 88 ^ 6% for those who had aortic root replacement (Pa 0:04). Five patients who had aortic root replacement required seven aortic root re-replacements: three for endocarditis and four for valve failure (biological valves). There have been no reoperations in patients who had aortic valve-sparing operations and annual Doppler echocardiography revealed mild or no aortic insufficiency in 39 patients and moderate aortic insufficiency in three. Conclusions: These data suggest that aortic valve-sparing operations are safe in patients with the Marfan syndrome and may provide better clinical outcomes than aortic root replacement. Since the size of the aneurysm often determines the feasibility of a valve-sparing procedure, we now recommend surgery when the diameter of the aortic root reaches 50 mm in patients with the Marfan syndrome who have echocardiographically normal aortic valve cusps. q 2000 Elsevier Science B.V. All rights reserved.

Die Finanzkrise hatte die deutsche Bankenlandschaft in ihren Grundfesten erschuttert. Selbst viele zuvor als solide eingeschatzte deutsche Hauser gerieten ins Wanken, als strukturierte Papiere, die etliche Milliarden Euro schwer waren, rasant an Wert verloren und die Bilanzen dramatisch belasteten. Die Politik ermoglichte den angeschlagenen Instituten deshalb auch, Teile ihres Portfolios in Bad Banks auszulagern. Dies offnete zugleich eine Tur fur Spezialisten, die zuvor eher in einer Nische agierten: De-Investitionsbanker – erfahrene Restrukturierungsexperten und Portfoliomanager, die sich innerhalb kurzester Zeit in die problematischen Anlagen einarbeiten, sie risikominimierend verwalten und letztlich abwickeln konnen.

Originalmente pensada como una constitución provisoria, la Ley Fundamental alemana se encuentra en vigor desde hace sesenta años y durante este tiempo ha ganado reputación a nivel nacional e internacional. A través del presente artículo se analizan el surgimiento y el desarrollo de la Ley Fundamental, los fundamentos de su éxito, el rol del Tribunal Constitucional Federal y su estado actual.