Piperacillin/tazobactam‐induced neurotoxicity in a hemodialysis patient: A case report

Antibiotics are potentially a cause of neurotoxicity in dialysis patients, the most common are the beta‐lactams as ceftazidime and cefepime, and few cases have been reported after piperacillin/tazobactam use. This report presents a case of a hypertensive and diabetic 67‐year‐old woman in regular hemodialysis, which previously had a stroke. She was hospitalized presenting pneumonia, which was initially treated with cefepime. Two days after treatment, she presented dysarthria, left hemiparesis, ataxia, and IX and X cranial nerves paresis. Computed tomography showed no acute lesions and cefepime neurotoxicity was hypothesized, and the antibiotic was replaced by piperacillin/tazobactam. The neurologic signs disappeared; however, 4 days after with piperacillin/tazobactam treatment, the neurological manifestations returned. A new computed tomography showed no new lesions, and the second antibiotic regimen withdrawn. After two hemodialysis sessions, the patient completely recovered from neurological manifestations. The patient presented sequentially neurotoxicity caused by two beta‐lactams antibiotics. This report meant to alert clinicians that these antibiotics have dangerous neurological effects in chronic kidney disease patients.     

Liquid phase sintering and characterization of SiC ceramics

The present study focuses on the sintering of silicon carbide-based ceramics (SiC) by liquid phase sintering (LPS) followed by characterization of the produced ceramics. AlN/Re₂O₃ mixtures were used as additives in the LPS process. In the first step, the LPS-SiC materials were produced in a graphite resistance furnace in the form of discs at different temperatures. The conditions with the best results regarding real density and relative density were taken as reference for sintering in the form of prismatic bars. In the second step, these samples were evaluated regarding fracture toughness (K_IC), by the Single Edge V Notch Beam – SEVNB – method, and flexural strength. K_IC behavior was evaluated according to the depth and curvature radius of the notches. Reliable K_IC values were presented when the ceramic displayed a small curvature radius at the notch tip. When the radius was large, it did not maintain the square root singularity of the notch tip. Tests were carried out to determine K_IC values in atmospheric air and water. K_IC results were lower in water than air, with a decrease ranging between 2.56% and 11.26%. The observations indicated a direct grain size correlation between K_IC values and fracture strength of the SiC ceramics.     

“Ärztliche Freiheit und Berufsethos“ — Hängen ärztliche Berufsfreiheit und ärztliches Berufsethos zusammen?

Ohne Zusammenfassung     

Wetting behaviour of silicon nitride ceramics by Ti–Cu alloys

The wetting of Ti–Cu alloys on Si₃N₄ was analyzed by the sessile drop method, using an imaging system with a CCD camera during the heating under argon flow. The contact angle was measured as a function of temperature and time. The samples were cut transversally and characterized by scanning electron microscopy and energy dispersive spectrometry (SEM/EDS). Wettability of the Ti–Cu alloy on Si₃N₄ is influenced by the reaction between the Ti and the ceramic. The TC1 and TC2 alloys presented low final contact angle values around 2° and 26°, respectively, indicating good wetting on Si₃N₄.     

A p‐version,first order shear deformation,finite element for geometrically non‐linear vibration of curved beams

A p‐version, hierarchical finite element for curved, moderately thick, elastic and isotropic beams is introduced. The convergence properties of the element are analysed and some results are compared with results published elsewhere or calculated using a commercial finite element package. It is verified that, with the proposed element, shear locking does not affect the computation of the natural frequencies and that low dimensional, accurate models are obtainable. Geometrically non‐linear vibrations due to finite deformations, which occur for harmonic excitations with frequencies close to the first three natural frequencies of vibration, are investigated using Newmark's method. The influence of the thickness, longitudinal inertia and curvature radius on the dynamic behaviour of curved beams are studied. Copyright © 2004 John Wiley & Sons, Ltd.