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RISS 인기검색어
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- 저자 : Claudio Amadio (검색결과 2 건)
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Claudio Amadio,Chiara Bedon 국제구조공학회 2014 Structural Engineering and Mechanics, An Int'l Jou Vol.51 No.1
The paper focuses on the dynamic response of a blast-invested glass-steel curtain wall supported by single-way pretensioned cables. In order to mitigate the critical components of the façade from severe structural damage, an innovative system able to absorb and dissipate part of the blast-induced stresses in the critical façade components is proposed. To improve the blast reliability of the studied glazing system, specifically, rigid-plastic and elastoplastic devices are introduced at the base and at the top of the vertical bearing cables. Several combinations and mechanical calibrations of these devices are numerically investigated and the most structurally and economically advantageous solution is identified. In conclusion, a simple analytical formulation totally derived from energetic considerations is also suggested for a preliminary estimation of the maximum dynamic effects in single-way cable-supported façades subjected to high-level blast loads.
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Acinetobacter Prosthetic Joint Infection Treated with Debridement and High-Dose Tigecycline
Andrea Vila,Hugo Pagella,Claudio Amadio,Alejandro Leiva 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.4
Prosthesis retention is not recommended for multidrug-resistant Acinetobacter prosthetic joint infection due to its high failure rate. Nevertheless, replacing the prosthesis implies high morbidity and prolonged hospitalization. Although tigecycline is not approved for the treatment of prosthetic joint infection due to multidrug resistant Acinetobacter baumannii, its appropriate use may preclude prosthesis exchange. Since the area under the curve divided by the minimum inhibitory concentration is the best pharmacodynamic predictor of its efficacy, we used tigecycline at high dose, in order to optimize its efficacy and achieve implant retention in 3 patients who refused prosthesis exchange. All patients with prosthetic joint infections treated at our Institution are prospectively registered in a database. Three patients with early prosthetic joint infection of total hip arthroplasty due to multidrug resistant A. baumannii were treated with debridement, antibiotics and implant retention, using a high maintenance dose of tigecycline (100 mg every 12 hours). The cases were retrospectively reviewed. All patients signed informed consent for receiving off-label use of tigecycline. Tigecycline was well tolerated, allowing its administration at high maintenance dose for a median of 40 days (range 30–60). Two patients were then switched to minocycline at standard doses for a median of 3.3 months in order to complete treatment. Currently, none of the patients showed relapse. Increasing the dose of tigecycline could be considered as a means to better attain pharmacodynamic targets in patients with severe or difficult-to-treat infections. Tigecycline at high maintenance dose might be useful when retention of the implant is attempted for treatment for prosthetic joint infections due to multidrug resistant Acinetobacter. Although this approach might be promising, off-label use of tigecycline should be interpreted cautiously until prospective data are available. Tigecycline is probably under-dosed for the treatment of implant and biofilm associated infections.
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