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Identification of Willem van Schaik, 2004.The alternative sigma factor Intrapulmonary Pharmacokinetics and Pharmacodynamics of Itraconazole and 14-Hydroxyitraconazole at Steady State. John E. Conte Jr., 2004.We determined the steady-state intrapulmonary pharmacokinetic and pharmacodynamic parameters of orally administered itraconazole (ITRA), 200 mg every 12 h (twice a day [b.i.d.]), on an empty stomach, for a total of 10 doses, in 26 healthy volunteers . Five subgroups each underwent standardized bronchoscopy and bronchoalveolar lavage (BAL) at 4, 8, 12, 16, and 24 h after administration of the last dose . ITRA and its main metabolite, 14-hydroxyitraconazole (OH-IT), were measured in plasma, BAL fluid, and alveolar cells (AC) using high-pressure liquid chromatography . Half-life and area under the concentration-time curves (AUC) in plasma, epithelial lining fluid (ELF), and AC were derived using noncompartmental analysis . ITRA and OH-IT maximum concentrations of drug (Cmax) (mean ± standard deviation) in plasma, ELF, and AC were 2.1 ± 0.8 and 3.3 ± 1.0, 0.5 ± 0.7 and 1.0 ± 0.9, and 5.5 ± 2.9 and 6.6 ± 3.1 µg/ml, respectively . The ITRA and OH-IT AUC for plasma, ELF, and AC were 34.4 and 60.2, 7.4 and 18.9, and 101 and 134 µg · hr/ml . The ratio of the Cmax and the MIC at which 90% of the isolates were inhibited (MIC90), the AUC/MIC90 ratio, and the percent dosing interval above MIC90 for ITRA and OH-IT concentrations in AC were 1.1 and 3.2, 51 and 67, and 100 and 100%, respectively . Plasma, ELF, and AC concentrations of ITRA and OH-IT declined monoexponentially with half-lives of 23.1 and 37.2, 33.2 and 48.3, and 15.7 and 45.6 h, respectively . An oral dosing regimen of ITRA at 200 mg b.i.d . results in concentrations of ITRA and OH-ITRA in AC that are significantly greater than those in plasma or ELF and intrapulmonary pharmacodynamics that are favorable for the treatment of fungal respiratory infection . Environmental Surveillance System To Track Wild Poliovirus Transmission. Jagadish M. Deshpande, 2003.Eradication of poliomyelitis from large metropolis cities in India has been difficult due to high population density and the presence of large urban slums . Three paralytic poliomyelitis cases were reported in Mumbai, India, in 1999 and 2000 in spite of high immunization coverage and good-quality supplementary immunization activities . We therefore established a systematic environmental surveillance study by weekly screening of sewage samples from three high-risk slum areas to detect the silent transmission of wild poliovirus . In 2001, from among the 137 sewage samples tested, wild poliovirus type 1 was isolated from 35 and wild poliovirus type 3 was isolated from 1 . Acute flaccid paralysis (AFP) surveillance indicated one case of paralytic poliomyelitis from the city . Phylogenetic analysis with complete VP1 sequences revealed that the isolates from environmental samples belonged to four lineages of wild polioviruses recently isolated from poliomyelitis cases in Uttar Pradesh and not to those previously isolated from AFP cases in Mumbai . Wild poliovirus thus introduced caused one case of paralytic poliomyelitis . The virus was detected in environmental samples 3 months before . It was found that wild polioviruses introduced several times during the year circulated in Mumbai for a limited period before being eliminated . Environmental surveillance was found to be sensitive for the detection of wild poliovirus silent transmission . Nucleotide sequence analysis helped identify wild poliovirus reservoir areas .
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