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1.
Elena Montecatine-Alonso María-Victoria Gil-Navarro Cecilia M. Fernández-Llamazares Aurora Fernández-Polo Pere Soler-Palacín Jesús Llorente-Gutiérrez María-Teresa Gómez-Travecedo Calvo María-Dolores Esquivel-Mora Icíar Pérez-Rodrigo José M. Cisneros Walter-Alfredo Goycochea-Valdivia Olaf Neth 《Enfermedades infecciosas y microbiología clínica》2019,37(5):301-306
Introduction
Antimicrobial defined daily dose (DDD), has limitations for antimicrobial consumption measurement in paediatrics. An alternative DDD design applicable for children is proposed.Methods
Children (<16 years-old) from 10 Spanish hospitals during a 12-months period were included. Weight for age (50th percentile) was calculated for the median age of the cohort using standardized World Health Organization tables. DDD (g) for each antimicrobial was calculated by multiplying the obtained weight times the recommended dose (mg/kg) of the antimicrobial for the most common infectious indication.Results
A total of 40,575 children were included. Median age was 4.17 (IQR: 1.36–8.98) and 4.81 (IQR: 1.42–9.60) years for boys and girls, respectively. Mean weight for this age was 17.08 kg. Standardized DDD for representative antimicrobials were calculated.Conclusions
A useful method for antimicrobial DDD measurement in paediatrics has been proposed and should be validated in future studies for its use in paediatric antimicrobial stewardship programmes. 相似文献2.
Sara Hernández Egido Ana de Luis Reboredo Alicia García Señán Ana Belén Gil González Juan Luis Muñoz Bellido José Manual González Buitrago Fernando Sánchez-Juanes 《Enfermedades infecciosas y microbiología clínica》2019,37(4):244-250
Introduction
We have developed a MALDI-TOF-mediated phenotypic method, which determines antibiotic susceptibility (AS) from positive blood cultures (BCs) in 2 h. We developed a software for process automation. We report results on Escherichia coli-positive BCs with cefotaxime (CTX) and ciprofloxacin (CIP).Methods
We studied CIP and CTX activity in 18 and 17 real E. coli-positive BCs, and in 56 and 45 spiked BCs, respectively. Positive BCs were incubated for 2 h without any antibiotics, and with 2 mg/l and 4 mg/l of CIP and CTX. The extraction was performed using ethanol/formic acid. Spectra were processed with specifically developed software which compares the peaks’ intensity and the size of specific peaks.Results
The set cut-off point was a 3-fold decrease in the summation of all peaks and/or the 5382m/z peak value (ribosomal protein L34). In simulated BCs, the correlation of CIP 2 mg/l and 4 mg/l with Etest® was 94.6% and 98.2%, respectively; for CTX 2 mg/l and 4 mg/l, this correlation was 95.6%. In real BCs, the correlations were 100% for CIP (2 mg/l and 4 mg/l) and 88.2% and 94.1% for CTX 2 mg/l and 4 mg/l, respectively. Resistant isolates were always correctly classified.Conclusion
This method provides accurate, fast and inexpensive AS information. The method can be automated, making it easier to implement in a microbiology laboratory routine. 相似文献3.
Monica Baumgardt Bay Marise Reis de Freitas Marcia Cavalcante Vinhas Lucas Elizabeth Cristina Fagundes de Souza Angelo Giuseppe Roncalli 《The Brazilian journal of infectious diseases》2019,23(1):2-7
Background
Men who have sex with men (MSM) account for the highest prevalence of HIV in Brazil. HIV testing allows to implement preventive measures, reduces transmission, morbidity, and mortality.Methods
We conducted a cross-sectional study to evaluate HIV testing during lifetime, factors associated with the decision to test, knowledge about HIV transmission, and use of condoms between MSM from the city of Natal, northeast Brazil.Results
Out of 99 participants, 62.6% had been tested for HIV during lifetime, 46.2% in the last year. The most frequent reported reason to be tested for HIV infection was curiosity (35.5%). Correct knowledge about HIV was observed in only 9.2% of participants. In multivariate analysis, age (PR 0.95; 95%CI, 0.91–0.99; p = 0.041) and previous syphilis test (PR 4.21; 95%CI, 1.52–11.70; p = 0.006) were associated with HIV testing.Conclusions
The frequency of HIV testing among MSM from Natal is rather low, especially in younger MSM, and knowledge about HIV transmission is inappropriate. 相似文献4.
5.
Mauricio Restrepo-Escobar Paula Andrea Granda-Carvajal Fabián Jaimes 《Reumatología clinica》2019,15(1):27-33
Objective
To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies.Methods
Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve.Results
Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959).Conclusion
In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. 相似文献6.
Background
Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.Objectives
To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.Methods
A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.Results
CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.Conclusion
Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria. 相似文献7.
Objective
To investigate the karyotype, clinical manifestations and natural and therapeutic outcome of Turner syndrome (TS) in China.Method
A total of 124 TS patients with definite diagnosis were included. Karyotype, main clinical signs, sexual development and therapeutic outcome were analyzed.Results
TS karyotype was classified in 4 types: monosomy (32.7%), mosaic (15.9%), variant (23.9%) and mosaic with variant (27.4%). All patients showed short stature, with mean adult height <145 cm. Sixteen percent of adolescent patients showed spontaneous breast development and 8% spontaneous menstruation. The rate of spontaneous sexual development was lowest in the monosomy karyotype. Common signs included cubitus valgus and wide breast space in about 50% of patients, epicanthus and skin nevus in 30% and webbed neck and shield chest in 10–20%. More than 10% of patients had associated heart, kidney or thyroid abnormalities. The rate of kidney malformation was highest in the monosomy karyotype. Growth hormone (GH) therapy can accelerate growth, with 7.6 cm and 6.7 cm increase in height in the first and second years of therapy respectively, slowing to 5.7 cm and 4.1 cm in the third and fourth years. Treated patients who reached nearly adult height were 10.2 cm taller than untreated patients. Therapeutic effect correlated with GH therapy duration.Conclusion
TS patients showed a variety of karyotypes, related to the diversity of clinical manifestations and outcomes. Sexual development and adult height were poorer in monosomy karyotypes than in other types. 相似文献8.
Luz Elena Espinosa de los Monteros-Pérez Rodolfo Norberto Jiménez-Juárez Demóstenes Gómez-Barreto Carlos Francisco Navas-Villar 《Enfermedades infecciosas y microbiología clínica》2019,37(1):41-44
Introduction
Streptococcus pneumoniae (Sp) is the main cause of community-acquired pneumonia in the elderly, hence the importance to establish the prevalence of nasopharyngeal colonization by different Sp serotypes in adults.Methods
from December 2009 to June 2010, nasopharyngeal cultures were taken from adults living in rural communities in Mexico for the isolation and serotyping of Sp by the Quellung reaction. Penicillin and ceftriaxone susceptibility tests were performed by the microdilution method.Results
two hundred and thirty-six adults over 50 years old, were included. The prevalence of colonization by Sp was 21.6%. The most frequent serotypes were 19A (21%), 6A (13%), 6B and 11A (11%). All isolates were susceptible to ceftriaxone, and 52.8% of the isolates showed penicillin minimal inhibitory concentrations ≥0.12 mg/L.Conclusion
this is the first study analyzing the nasopharyngeal colonization by Sp in adults in Mexico. Serotypes not included in any of the pneumococcal vaccines were frequently identified. 相似文献9.
Brigida E. Annicchiarico Concetta Santonocito Massimo Siciliano Margherita Scapaticci Donatella Guarino Carmine Di Stasi Maria E. Riccioni Enrico Di Stasio Ettore Capoluongo Antonio Gasbarrini 《Digestive and liver disease》2019,51(2):293-296
Background
In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed.Aim
The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure.Methods
Fifty-one consecutive cirrhotic patients were divided based on ACE genotype (DD, ID, and II). Kidney and liver function tests, upper endoscopy, and hepatic venous pressure gradient measurement (HVPG) were performed in all patients.Results
The presence of the ACE I allele was associated with a higher HVPG value (18.7 ± 6.4 vs 10.3 ± 6.3 mmHg; P < .001), higher frequency of large gastrooesophageal varices (59.3% vs 25.0%; P < .05), and higher frequency of variceal bleeding (63.0% vs 29.2%; P < .05). No significant differences were found between patients with and those without the ACE I allele regarding Child-Pugh score, MELD score, ascites, and hepatic encephalopathy.Conclusion
ACE I/D polymorphism seems to influence the severity of portal hypertension and the risk of variceal bleeding in liver cirrhosis, regardless of the severity of liver disease. 相似文献10.
D. Ozceker F. Haslak F. Dilek S. Sipahi E. Yucel N. Guler Z. Tamay 《Allergologia et immunopathologia》2019,47(1):47-51
Background
Atopic dermatitis is a common illness in childhood. Children with atopic dermatitis are prone to develop cutaneous sensitization due to skin barrier dysfunction.Aim
The aim of this study was to evaluate the frequency of cutaneous sensitizations in patients with atopic dermatitis and to identify the most frequent causative allergens.Study design
The study group consisted of 112 children with atopic dermatitis, aged 1–18 years (median 88.5 months) and 39 healthy controls, aged 1–8 years (median 88.48 months).Methods
The diagnosis of atopic dermatitis was established by modified Hanifin and Rajka criteria; severity of the disease was assessed by scoring of atopic dermatitis. Serum blood eosinophil count, total IgE and skin prick tests for common aeroallergens and food allergens were performed. Patch tests with cosmetic series and European standard patch test series (Stallegenes© Ltd, Paris, France) were applied.Results
Of the children with atopic dermatitis, 17% (n = 19) were sensitized to either cosmetic or standard series or both of them; no children in the control group had a positive patch test (p = 0.001). Atopy and severity of atopic dermatitis was not a significant risk factor for cutaneous sensitization. The most common allergens were Nickel sulphate and Methychloroisothiazinolone (4.5% and 4.5%) in the European standard patch test and cocamidoproplybetaine (12.5%) in the cosmetic series patch test.Conclusion
Cutaneous sensitization can develop in children with atopic dermatitis, therefore allergic contact dermatitis should be kept in mind. 相似文献11.
12.
Objective
The purpose of this systematic review was to examine the effect of antipsychotic medication on dysphagia based on clinical case reports.Patients and methods
Literature searches were performed using the electronic databases PubMed and Embase. In PubMed, we used the MeSH terms “antipsychotic agents” OR “tranquilizing agents” combined with “deglutition disorders” OR “deglutition”. In Embase, we used the Emtree terms “neuroleptic agents” combined with “swallowing” OR “dysphagia”. Two reviewers assessed the eligibility of each case independently.Results
A total of 1043 abstracts were retrieved, of which 36 cases met the inclusion criteria; 14 cases were related to typical antipsychotics and 22 to atypical antipsychotics. Dysphagia occurred together with extrapyramidal symptoms in half of the cases and was the only prominent symptom in the other half. The most common strategy against dysphagia was changing to another antipsychotic (n = 13, 36.1%).Conclusions
The data from this review indicate that antipsychotics can increase the prevalence of dysphagia. 相似文献13.
Rodrigo Tejos Javier Chahuán Thomas Uslar Martin Inzunza Ignacio Villagrán Valentina Riquelme Oslando Padilla Margarita Pizarro Marcia Corvetto Julián Varas Arnoldo Riquelme 《Gastroenterologia y hepatologia》2019,42(4):239-247
Background and aims
Abdominal paracentesis is an area that every general physician should know about, and the current learning model is unsafe for patients. Simulation allows students to develop their skills prior to clinical confrontation with minimal risks. The aims of this study were to design and evaluate a paracentesis simulation workshop for undergraduate students.Methods
A workshop was implemented using a specially designed and validated simulation model for abdominal paracentesis. The simulated technique considered the recognition of materials, operator equipment, asepsis, anesthesia, puncture and obtaining liquid, collecting samples for analysis, withdrawal of the material and occlusion. A 24-point direct observation checklist was administered to assess the student. We assessed two students at the beginning of the workshop and all the students at the end. A perception survey was applied to attendees at the end of the workshop.Results
247 students were included and a workshop that involved 8 students per session was held. Students significantly improved their skills comparing pre- and post-evaluation results [13.36 ± 4.46 (55.7%) vs. 22.3 ± 1.83 (92.9%) respectively (n = 69) p < 0.001]. The students’ perception questionnaire (n = 38) showed that the training sessions were highly valued, averaging 4.8 ± 0.38 on a Likert scale of 1–5.Conclusions
Simulated training in abdominal paracentesis is a very good teaching method. This teaching methodology should be highly recommended as an educational strategy in medicine because it could accelerate the acquisition of clinical skills in a safe learning environment. 相似文献14.
Pauline Sarkis Muriel Rabilloud Jean-Christophe Lifante Anna Siamand Emmanuel Jouanneau Emmanuel Gay Philippe Chaffanjon Olivier Chabre Gérald Raverot 《Annales d'endocrinologie》2019,80(1):32-37
Objective
Bilateral adrenalectomy (BADX) has become an important treatment of Cushing's disease (CD), especially when other treatment options have failed. The aim of this study was to evaluate the long-term quality of life (QoL) of patients having undergone BADX for CD, in comparison to other therapeutic options.Methods
Thirty-four patients with CD were identified in two French centers: 17 underwent BADX and the remaining 17 one or more of the following treatments: surgery, medical therapy or radiotherapy. Three questionnaires were filled in by each patient in order to evaluate their QoL: Short Form-36 Health Survey (SF-36), Cushing QoL questionnaire and Beck depression inventory (BDI).Results
The mean age of patients was 49.3 ± 15.2 years. Average time lapse between diagnosis and BADX was 6.1 years. Results from each questionnaire adjusted to age showed a lower QoL among patients who underwent BADX. These were significant in most aspects of the SF-36 questionnaire (bodily pain P < 0.01, general health P < 0.01, vitality P ≤ 0.05, social functioning P ≤ 0.05), as well as in the Cushing QoL questionnaire (P < 0.05) and BDI (P ≤ 0.05). Adrenal insufficiency appeared to be the major predictor of poor QoL whatever their initial treatment.Conclusions
Despite their clinical remission, patients who undergo BADX appear to be at a greater risk of suffering an impaired QoL due to more prolonged period of time with imperfectly controlled hypercortisolism combined with definitive adrenal insufficiency. 相似文献15.
K. Douros D. Kotzia C. Kottaridi A. Giotas B. Boutopoulou E. Bozas V. Matziou K. Priftis V. Papaevangelou 《Allergologia et immunopathologia》2019,47(3):260-264
Aim
To prospectively evaluate interferences between viruses of the upper respiratory tract in asymptomatic preschool children.Methods
Nasal-pharyngeal swabs from 233 preschool aged children were prospectively collected over four consecutive time periods, during one school year. The samples were tested using a RT-PCR DNA/RNA microarray system for nine respiratory viruses.Results
Respiratory syncytial virus (RSV) was a predictor of the presence of influenza virus (INFL) (OR: 9.12, CI: 1.52–54.75, p = 0.016), and similarly, INFL predicted the presence of RSV (OR: 4.01, CI: 1.14–14.16, p = 0.030). Also, rhinovirus (RV) was a predictor of adenovirus (ADV) presence (OR: 3.66, CI: 1.10–12.14, p = 0.034), and similarly, ADV predicted the presence of RV (OR: 4.05, CI: 1.02–16.05, p = 0.046). No other significant associations between viruses were observed.Conclusion
Our results indicate that respiratory viruses found in carrier stage in asymptomatic children may interact with other viruses and even facilitate their settling in the upper respiratory tract. The pathophysiological role of these interactions is not yet clear. 相似文献16.
Lucía Silva-Fernández Teresa Otón Anca Askanase Patricia Carreira Francisco Javier López-Longo Alejandro Olivé Íñigo Rúa-Figueroa Javier Narváez Esther Ruiz-Lucea Mariano Andrés Enrique Calvo Francisco Toyos Juan José Alegre-Sancho Eva Tomero Carlos Montilla Antonio Zea Esther Uriarte Jaime Calvo-Alén José Luis Andreu 《Reumatología clinica》2019,15(1):34-42
Objectives
The course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.Methods
We conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.Results
Mean age was 34.2 ± 12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98 ± 0.78 mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24 h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.Conclusions
Pure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis. 相似文献17.
Konstantinos Douros Maria-Ioanna Thanopoulou Barbara Boutopoulou Anna Papadopoulou Anastassios Papadimitriou Andrew Fretzayas Kostas N. Priftis 《Allergologia et immunopathologia》2019,47(3):209-213
Introduction
There is accumulated evidence supporting a beneficial role of Mediterranean diet (MD) in the control of asthma symptoms. The aim of this study was to investigate the relationships between adherence to MD and serum levels of certain cytokines namely, interleukin (IL)-4, and IL-17 known to have a pathogenetic role in the airway changes associated with asthma.Methods
We measured serum IL-4, IL-33, and IL-17, in 44 asthmatic and 26 healthy children, 5–15 years old. Their adherence to MD was estimated with the Mediterranean Diet Quality Index for children and adolescents (KIDMED) score.Results
KIDMED score did not differ between the two groups (P = 0.59) and was not correlated with any of the three measured cytokines. However, when the analysis was restricted only to asthmatic children, the KIDMED score was correlated with IL-4, IL-33, and IL-17 (Beta: ?0.56, P = 0.007; Beta: 0.57, P = 0.010; Beta: ?0.62, P = 0.017, respectively).Conclusion
Our results indicate that MD can modulate the production of some of the main inflammatory mediators of asthma, in asthmatic children. 相似文献18.
Borja Suberviola Bernardo Alio Lavin Andrés Fernando Jimenez Sonia Perez-San Martin Maite Garcia-Unzueta Miguel Santibañez 《Enfermedades infecciosas y microbiología clínica》2019,37(4):239-243
Background
The aim of this study was to assess the prognostic value of vitamin D, vitamin D binding protein (VDBP) and vitamin D-related peptides in septic shock patients in relation to hospital mortality.Methods
This is a single-center, prospective, observational study that included all consecutive patients meeting criteria for septic shock who were admitted to the ICU. VDBP, 25-hydroxy vitamin D, 1,25-dihydroxy vitamin D, cathelicidin and beta-defensin levels were determined in blood samples obtained on admission to the ICU.Results
Seventy-five patients were studied. The best area under the curve (AUC) for prediction of in-hospital mortality was for VDBP (0.78), with a negative predictive value of 85.45% for the optimal cut-off point. VDBP was also the only variable that had a statistically significant association with a higher risk of in-hospital mortality, regardless of other assessed variables and pre-determined confounders: adjusted odds ratio of 5.20 (95% confidence interval: 1.21–22.36). When restricted to patients with vitamin D insufficiency (n = 54), the AUC was 0.77, and the adjusted OR 12.22 (95% CI: 1.46–102.14; p = 0.021) for in-hospital mortality.Conclusions
VDBP levels showed a statistically significant association with in-hospital mortality, supporting the clinical utility of VDBP as a good prognostic marker in septic shock patients. Vitamin D and vitamin D-related peptides are not associated with in-hospital mortality. These results should be confirmed in a multicentre study with a larger sample size. 相似文献19.
S. Miceli Sopo G. Gurnari S. Monaco A. Romano L. Liotti B. Cuomo I. Dello Iacono L. Badina G. Longo M. Calvani A. Giannone C. Calabrò G. Scala M.C. Verga 《Allergologia et immunopathologia》2019,47(3):277-281