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- Pfaller, M.A., et al.
(författare)
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Twelve years of fluconazole in clinical practice : Global-trends in species distribution and fluconazole susceptibility of bloodstream isolates of Candida
- 2004
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Ingår i: Clinical Microbiology and Infection. - : Elsevier BV. - 1198-743X .- 1469-0691. ; 10:SUPPL. 1, s. 11-23
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Tidskriftsartikel (refereegranskat)abstract
- We determined the species distribution and in-vitro susceptibility of 6082 bloodstream infection (BSI) isolates of Candida spp. collected from 250 medical centres in 32 nations over a 10-year period from 1992 through 2001. The species included 3401 C. albicans, 984 C. glabrata, 796 C. parapsilosis, 585 C. tropicalis, 153 C. krusei, 67 C. lusitaniae, 48 C. guilliermondii, 10 C. famata, 10 C. kefyr, six C. pelliculosa, five C. rugosa, four C. lipolytica, three C. dubliniensis, three C. inconspicua, two C. sake and one isolate each of C. lambica, C. norvegensis and C. zeylanoides. Minimum inhibitory concentration determinations were made using the National Committee for Clinical Laboratory Standards reference broth microdilution method. Variation in the rank order and frequency of the different species of Candida was observed over time and by geographic area. The proportion of BSI due to C. albicans and C. glabrata increased and C. parapsilosis decreased over time in Canada, the USA and Europe. C. glabrata was an infrequent cause of BSI in Latin America and the Asia-Pacific region. Very little variation in fluconazole susceptibility was observed among isolates of C. albicans, C. tropicalis and C. parapsilosis. These species accounted for 78% of all BSI and remained highly susceptible (91-100% susceptible) to fluconazole from 1992 to 2001 irrespective of geographic origin. The prevalence of fluconazole resistance among C. glabrata isolates was variable both over time and among the various countries and regions. Resistance to fluconazole among C. glabrata isolates was greatest in the USA and varied by US census region (range 0-23%). These observations are generally encouraging relative to the sustained usefulness of fluconazole as a systemically active antifungal agent for the treatment of candida BSI. © 2004 Copyright by the European Society of Clinical Microbiology and Infectious Diseases.
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| 2. |
- Kleiven, Svein, et al.
(författare)
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Correlation of an FE Model of the Human Head with Local Brain Motion : Consequences for Injury Prediction
- 2002
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Ingår i: Stapp Car Crash Journal. - 1532-8546. ; 46, s. 123-144
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Tidskriftsartikel (refereegranskat)abstract
- A parameterized, or scalable, finite element (FE) model of the human head was developed and validated against the available cadaver experiment data for three impact directions (frontal, occipital and lateral). The brain material properties were modeled using a hyperelastic and viscoelastic constitutive law. The interface between the skull and the brain was modeled in three different ways ranging from purely tied (no-slip) to sliding (free-slip). Two sliding contact definitions were compared with the tied condition. Also, three different stiffness parameters, encompassing the range of published brain tissue properties, were tested. The model using the tied contact definition correlated well with the experimental results for the coup and contrecoup pressures in a frontal impact while the sliding interface models did not. Relative motion between the skull and the brain in lowseverity impacts appears to be relatively insensitive to the contact definitions. It is shown that a range of shear stiffness properties for the brain can be used to model the pressure experiments, while relative motion is a more complex measure that is highly sensitive to the brain tissue properties. Smaller relative motion between the brain and skull results from lateral impact than from a frontal or occipital blow for both the experiments and FE simulations. The material properties of brain tissue are important to the characteristics of relative brain-skull motion. The results suggest that significantly lower values of the shear properties of the human brain than currently used in most three-dimensional (3D) FE models today are needed to predict the localized brain response of an impact to the human head.
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