Determinants of lymph node resolution in patients of tubercular lymphadenitis treated with anti tuberculous chemotherapy: A hospital based longitudinal study

IntroductionThe variable course of illness in patients of Tubercular lymphadenitis remains a therapeutic challenge to treating physicians in a significant proportion of patients. This study was aimed to explore the possible determinants which could predict the outcome of this subgroup of patients.MethodologyThis was a prospective cohort study where 94 patients of TB lymphadenitis were enrolled who could be followed up till the end of treatment. They were evaluated in the beginning and monitored till the end of treatment keeping into account the clinical behaviour of lymph nodes during the course of Anti tubercular chemotherapy.ResultsOut of 94 patients, 60 had their lymph nodes resolved at the end of prescribed treatment duration wheras 34 were classified as partial responders. Another 26 amongst them had their nodes resolved by an extension of continuation phase by 3–6 months. Presence of bilateral and multiple lymph nodes, necrosis on Fine needle aspiration at initial diagnosis and occurrence of Paradoxical upgrading reaction were associated with the partial resolution of lymph nodes at the end of stipulated ATT duration.ConclusionTreatment duration should be individualized by the treating physicians. Certain parameters mentioned above can be taken as warning signals of patients ending up as partial responders and hence the need of a prolonged extension phase.     

男性尿失禁患者留置导尿与使用保鲜袋接尿效果比较

目的：探讨男性尿失禁患者留置导尿与使用保鲜袋接尿并发症发生率对比,研究更适合男性尿失禁患者接尿方法。方法回顾我院综合病房2012年5月1日~2013年9月30日就诊男性尿失禁患100例,按入院时间分为观察组与对照组50例,观察组应用保鲜袋接尿法,对照组应用留置导尿。结果通过1个月观察期间,两组并发症对比,观察组尿道感染与阴茎糜烂、管道脱落、漏尿、4 w总费用、患者满意度有显著差异,差异有统计学意义(<0.05)。结论男性尿失禁患者使用保鲜袋接尿方法避免了有创留置导尿,并减少了导管相关性尿路感染的发生率,减轻患者痛苦与经济负担,同时减少了漏尿与皮肤损伤的问题,提高了患者舒适度,方便可行,是与家庭护理紧密衔接的方法,值得在长期卧床尿失禁患者中普遍采用。     

Eculizumab as a bridge to immunosuppressive therapy in severe cold agglutinin disease of anti‐Pr specificity

Severe cold agglutinin disease with hemodynamic compromise requires rapid stabilization of the autoimmune hemolytic anemia as a bridge to the immunosuppressive effect of rituximab. Herein, we describe eculizumab treatment of severe complement‐mediated hemolysis in a patient whose hemodynamic status deteriorated in spite of supportive blood transfusions and therapeutic plasma exchange.     

Stability of Reconstituted Telavancin Drug Product in Frozen Intravenous Bags

Background and Objective:

Intravenous (IV) infusions of telavancin for injection are generally administered in-hospital, but in some circumstances they may be administered in an outpatient environment. In that setting, antibiotics may be premixed and frozen. This study determined the chemical stability of nonpreserved telavancin in various commonly used reconstitution diluents stored in IV bags (polyvinyl chloride [PVC] and PVC-free) at -20°C (-4°F) without light.

Methods:

Telavancin (750 mg/vial) was reconstituted with 5% dextrose injection USP (D5W) or 0.9% sodium chloride injection USP (NS) to obtain drug solutions at approximately 15 mg/mL. Infusion solutions of telavancin at diluted concentrations of 0.6 mg/mL and 8.0 mg/mL covering the range utilized in clinical practice were prepared in both PVC and PVC-free IV bags using D5W or NS solutions. The infusion solutions were stored under frozen conditions (-20°C ± 5°C [-4°F ± 41°F]) and the chemical stability was evaluated for up to 32 days. Telavancin concentration, purity, and degradant levels were determined using a stability-indicating high-performance liquid chromatography (HPLC) method.

Results:

Telavancin IV infusion solutions in D5W or NS at 0.6 mg/mL and 8 mg/mL and stored at -20°C (-4°F) met the chemical stability criteria when tested on days 0, 7, 14, and 32. The assayed telavancin concentration at each time point was within 97% to 103% of the initial mean assay value. The total degradants quantified by the HPLC stability-indicating method did not show any significant change over the 32-day study period.

Conclusion:

Telavancin IV infusion solutions (in D5W or NS) in both PVC and PVC-free IV bags were stable for at least 32 days when stored at -20°C (-4°F) without light. These results provide prolonged frozen stability data further to that previously established for 7 days under refrigerated conditions (2°C-8°C [36°F -46°F]), and for 12 hours at room temperature when diluted into IV bags containing D5W, NS, or lactated Ringer’s solution.     

我院2013年大肠埃希菌分布与耐药性分析

目的：了解南方医科大学附属郑州人民医院2013年大肠埃希菌分布及其对常用抗菌药物的耐药性,为临床选择抗菌药物提供参考。方法对2013年各科室标本中分离的630株大肠埃希菌进行抗菌药物敏感试验,依据2010年 CLSI 标准判读,并进行分析。结果630株大肠埃希菌中以中段尿、脓液及痰液检出最多,分别占50.00％、26.67％、17.94％。大肠埃希菌对一、二、三代头孢菌素,庆大霉素及喹诺酮类药物的耐药率较高,对阿米卡星、头孢西丁、碳青霉烯类抗菌药物、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的敏感性好,但出现了2株耐碳青霉烯类抗菌药物的大肠埃希菌。结论大肠埃希菌是泌尿道感染的常见致病菌,其对常用的抗菌药物耐药率较高。规范使用抗菌药物对防止和延缓细菌耐药具有重要意义。     

冠心病不同类型间斑块稳定性相关指标的比较研究

目的　比较血清抗氧化低密度脂蛋白 (oxLDL)抗体、细胞间黏附分子 1(ICAM 1)、血管细胞黏附分子 1(VCAM 1)和E 选择素水平对不同类型冠心病斑块稳定性的评价意义。方法　用酶联免疫吸附法 (ELISA)检测了 10 0例冠心病患者 (17例急性心肌梗死 ,4 1例不稳定性心绞痛 ,4 2例稳定性心绞痛 )及 31例正常健康对照者血清ICAM 1、VCAM 1、E 选择素和血清抗oxLDL抗体水平 ,并比较上述各指标水平与不同类型冠心病斑块稳定性之间的关系。结果　血清ICAM 1水平在急性心肌梗死组 (76 4± 111)ng/ml和不稳定性心绞痛组 (70 9± 10 0 )ng/ml明显高于稳定性心绞痛组 (6 0 7± 83)ng/ml,和正常对照组 (6 0 3± 90 )ng/ml,P <0 0 1;血清VCAM 1水平在急性心肌梗死组 (185 5± 6 6 6 )ng/ml和不稳定性心绞痛组 (172 4± 5 5 5 )ng/ml明显高于稳定性心绞痛组 (136 0± 36 0 )ng/ml,和正常对照组 (10 39± 319)ng/ml,P <0 0 1;血清E 选择素水平在急性心肌梗死组 (5 4± 19)ng/ml和不稳定性心绞痛组 (5 3± 2 2 )ng/ml明显高于稳定性心绞痛组 (39± 19)ng/ml,和正常对照组 (38± 14 )ng/ml,P <0 0 5 ;血清抗oxLDL抗体水平在急性心肌梗死组 (1 39± 0 6 8)和不稳定性心绞痛组 (1 35± 0 6 2 )明显高于稳定性心绞痛组 (0     

对574名门诊体检者及部分家畜感染戊型肝炎病毒的调查

通过调查戊型肝炎病毒 (HEV)在门诊体检者和不同动物中的分布情况 ,探讨 HEV的传播方式 ,随机检测了本院门诊来自乌鲁木齐地区的维吾尔族、汉族和哈萨克族 5 74名健康体检者血清以及屠宰场 132只不同种类的健康家畜全血 ,采用双抗原夹心 EL ISA法检验血清中抗 - HEV- Ig G抗体 ,结果人群总感染率为 36 .6 % ,其中男性为 36 .5 %(12 2 / 334) ,女性为 36 .7% (88/ 2 4 0 ) ,HEV感染在性别上无显著差异 (P>0 .0 5 ) ,而在汉、维、哈三个不同民族中 ,HEV感染率分别为 73%、2 0 %和 9.8% ,汉族显著高于其它两个民族 (P<0 .0 1) ,维族显著高于哈族 (P<0 .0 5 ) ,在猪、牛、山羊和绵羊四种家畜中 ,猪的 HEV感染率显著高于其它三种动物 (P<0 .0 1) ,提示人类感染 HEV可能与饮食习惯和卫生条件有关 ,也可能与动物的传播有关