Epidemiology and cost implications of candidemia,a 6‐year analysis from a developing country

Surveillance of candidemia is essential to monitor trends in species distribution and change in the incidence and antifungal resistance. In this study, we aimed to investigate prevalence, resistance rates, antifungal utilization and costs. A 6‐year retrospective analysis of the data belonging to patients with candidemia hospitalized between 2010 and 2016 was performed. The annual usage of fluconazole and caspofungin and the usage of these antifungals in different units were described in defined daily doses (DDD) per 1000 patient days. In total, 351 patients of candidemia were included. Median age of the patients was 45 (0‐88) and 55.1% of them were male. Overall, 48.1% of the candidemia episodes (169/351) were due to C. albicans, followed by C. parapsilosis (25.1%), C. glabrata (11.7%). Length of hospital stay was longer with a median of 20 days among patients with non‐albicans candidemia. Presence of a central venous catheter was found to be an associated risk for candidemia caused by non‐albicans strains. Annual incidence of candidemia increased from 0.10 to 0.30 cases/1000 patient days. Antifungal use was increased over years correlated with the cost paid for it. The policy against candidemia should be specified by each institution with respect to candidemia prevalence, resistance rates, antifungal use and costs.     

Ein Fall von angeborener Divertikelbildung des Blinddarms

Ohne Zusammenfassung     

Über die Divertikulose und Divertikulitis des Dickdarmes

Zusammenfassung Bericht über Vorkommen, H?ufigkeit und Pathogenese der falschen Divertikel(Graser). Abgrenzung der Divertikulose und Divertikulitis. Er?rterungen über die Pathogenese, klinischen Bilder und Diagnostik der Divertikulitis. Bericht über 6 Beobachtungen der Klinik, von denen 3 operiert wurden, davon eine mit t?dlichem Ausgang. Er?rterungen über die Therapie, insbesondere unter den Gesichtspunkten der Indikationsstellung und der Operationsverfahren. Vor einem zu radikalen Vorgehen ist zu warnen.     

Septische Spondylitis bei Fremdkörperperforation. Bericht über einen Fall

Ohne Zusammenfassung     

Comparison of collagen biomatrix and omentum effectiveness on peripheral nerve regeneration

Despite the presence of various nerve coaptation materials and techniques, achievement of the functional nerve regeneration is still inadequate. This study was aimed to compare the effectiveness of conduit composed of collagen biomatrix and omentum graft on peripheral nerve regeneration. Thirty-five male Wistar rats were divided into four groups. In the control group, the right sciatic nerve was skeletonized from the sciatic notch till the point of bifurcation. In the primary epineural repair group, the nerve was transected 1 cm proximal to the bifurcation with a sharp pair of micro scissors and then repaired with four epineural sutures. In the collagen biomatrix group, the epineural repaired nerve was wrapped with collagen biomatrix. In the collagen group, the epineural repaired nerve was wrapped with the nonpediculated omentum. Assessment of the nerve regeneration was based on functional (Walking Track Analysis, Electrophysiological Measurements), histological, and morphometric criteria. Light and electron microscopic examinations showed that collagen-biomatrix-wrapped specimens have the best regeneration. The electrophysiological study confirmed the recovery of electrical activity in the regenerated axons.     

Investigation of epidemiology of neurotrauma in the Republic of Guinea

The paper focuses on analysis of incidence of neurotrauma in economically underdeveloped country such as Republic of Guinea. It is found that leading etiology of central nervous system injuries are road accidents and indoor traumatism. Investigation of system of medical care revealed its poor condition and severe defects which prevent practical application of evidence-based recommendations for management of traumatic brain injury in underdeveloped countries including Republic of Guinea. Development of multiplanar strategy of control of neurotrauma is required which can be achieved only in case of massive governmental and international aid.     

Hereditary lacrimal fistula

Hereditary lacrimal fistula is a rare developmental anomaly. We report three patients with congenital lacrimal fistulae in the same family. Only one of our cases had bilateral lacrimal fistula while two had unilateral lacrimal fistulae. No other systemic or ocular anomaly was found in the affected subjects. In the absence of significant symptoms, we did not feel the necessity of any treatment for these lacrimal fistulae. The presence of a lacrimal fistula is an indication for the search for a variety of systemic and ocular associations in affected patients.