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11.
Diamantis I Tsilimigras Timothy Michael Pawlik Dimitrios Moris 《World journal of gastroenterology : WJG》2021,27(15):1524-1530
The concept of textbook outcome (TO) has recently gained popularity in surgical research and has been used to evaluate the quality or success of different surgical procedures, including hepatopancreatobiliary (HPB) operations. TO consists of individual outcome parameters that each reflect different domains of care including structure, process, and individual outcomes; in turn, the composite TO metric represents the optimal course after a surgical episode. TO can be used to assess patient-level outcomes, hospital performance, center designation and quality metrics. In addition to being an outcome measurement, TO may also be linked to healthcare costs. Future efforts should be directed towards establishing a universal definition of TO in HPB surgery so that surgeons and hospitals can assess and compare outcomes, identify shortcomings and improve real world patient outcomes. 相似文献
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Kévin Diallo Nathalie Thilly Amandine Luc Guillaume Beraud Önder Ergonul Maddalena Giannella Diamantis Kofteridis Tomislav Kostyanev José Ramón Paňo-Pardo Pilar Retamar Winfried Kern Céline Pulcini 《International journal of antimicrobial agents》2018,51(5):794-798
Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Their practices were evaluated using six clinical vignettes presenting uncomplicated BSI cases. A total of 616 professionals from 56 countries participated [333/616 (54%) infectious diseases specialists, 188/616 (31%) clinical microbiologists], of whom 76% (468/616) were members of an antimicrobial stewardship team. Large variations in practice were noted, in particular for the Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa vignettes. Echocardiography was considered standard of care by 81% (373/459) of participants for MRSA, 78% (400/510) for methicillin-susceptible S. aureus and 60% (236/395) for Candida albicans. Antimicrobial combination therapy was recommended by 2% (8/360) of respondents for C. albicans, 11% (43/378) for E. coli, 27% (114/420) for MRSA and 39% (155/393) for E. faecalis. Intravenous-to-oral switch was considered in 68% (285/418) for MRSA, 79% (306/388) for E. faecalis, 72% (264/366) for P. aeruginosa and 75% (270/362) for C. albicans. In multivariable analysis, IDSA guideline-compliant practice was more frequent among participants belonging to an antimicrobial stewardship team (aOR?=?1.7, P?=?0.018 for the MRSA vignette; and aOR?=?2.0, P?=?0.008 for the candidaemia vignette). This survey showed large variations in practice among infection specialists. International guidelines on management of BSI are urgently needed. 相似文献
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Giamarellos-Bourboulis EJ Plachouras D Skiathitis S Raftogiannis M Dionyssiou-Asteriou A Dontas I Karayannacos PE Giamarellou H 《The Journal of antimicrobial chemotherapy》2003,51(2):423-426
Three multidrug-resistant strains of Pseudomonas aeruginosa were incubated ex vivo with sera sampled after a 10 min intravenous infusion of 25 mg/kg of arachidonic acid (AA) in 10 rabbits in the presence of ceftazidime and amikacin. Lipid peroxidation was assessed during bacterial growth. A statistically significant decrease in bacterial cells was found by the interaction of antimicrobials and serum sampled in the middle of infusion and 15 and 30 min after infusion of AA and was accompanied by elevated levels of malonodialdehyde. This effect of AA is probably attributed to lipid peroxidation and raises the possibility of its application in experimental infections. 相似文献
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Strazzulla Alessio Postorino Maria Concetta Youbong Tracie Rouyer Maxence Flateau Clara Chakvetadze Catherine de Pontfarcy Astrid Pitsch Aurelia Jochmans Sebastien Belfeki Nabil Monchi Mehran Diamantis Sylvain 《European journal of clinical microbiology & infectious diseases》2021,40(7):1511-1516
European Journal of Clinical Microbiology & Infectious Diseases - This is a subanalysis of a previous study which compared the effectiveness of trimetoprim-sulfametoxazole (TMP-SMX) with all... 相似文献
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Bostantjopoulou S Katsarou Z Georgiadis G Zafiriou D Kazis A 《Clinical neuropharmacology》2002,25(2):115-118
The purpose of this study was to evaluate the effect of amantadine sulfate infusion on the N30 component of the median nerve short-latency somatosensory evoked potentials (SSEPs) in patients with Parkinson's disease (PD). Twenty patients with advanced PD and severe motor fluctuations received a 6-day course of amantadine sulfate infusion (400 mg/day) plus their usual levodopa medication. Patients were assessed clinically by means of the Unified Parkinson's Disease Rating Scale (UPDRS-III and -IV). SSEPs to median nerve stimulation were recorded from the parietal and frontal regions before and after the 6-day course of amantadine infusion. Mean UPDRS motor score during the ON and OFF phase improved after amantadine infusion, as did motor fluctuations. SSEP changes resulting from amantadine sulfate treatment were observed in the P20-N30 amplitude as follows: Mean P20-N30 amplitudes before and after treatment were 2.15 +/- 1.11 microV and 3.06 +/- 1.19 microV respectively (p = 0.000), whereas mean N30-P40 amplitude increased from 2.7 +/- 1.6 microV to 3.9 +/- 1.3 microV after treatment (p = 0.000). Our results indicate that coincident to its clinical impact, amantadine infusion in patients with PD affects electrophysiologic parameters as well. 相似文献
19.
Interaction of Felbamate with Several Other Antiepileptic Drugs Against Seizures Induced by Maximal Electroshock in Mice 总被引:5,自引:5,他引:0
Robert Gordon Margaret Gels Joseph Wichmann William Diamantis R. Duane Sofia 《Epilepsia》1993,34(2):367-371
Summary: The anticonvulsant effects of felbamate (FBM) alone or in combination with phenytoin (PHT), carbamazepine (CBZ), valproate (VPA), or phenobarbital (PB) were investigated against maximal electroshock (MES) seizures in mice. Nonprotective doses of the prototype antiepileptic drugs (AEDs) enhanced the protective effects of FBM against electrically induced seizures, as shown by significant reduction of FBM ED50 values. Toxicity as determined by rotorod test was not significantly potentiated, however, and the protective index (PI = TD50 /ED50 ) of FBM was increased by >100% for each AED interaction. The increase in anticonvulsant potency of FBM after its combination with nonprotective doses of AEDs could not be accounted for by a pharmacokinetic mechanism. 相似文献
20.
Bile Duct Injuries Associated with Laparoscopic and Open Cholecystectomy: An 11-Year Experience in One Institute 总被引:7,自引:0,他引:7
Diamantis T Tsigris C Kiriakopoulos A Papalambros E Bramis J Michail P Felekouras E Griniatsos J Rosenberg T Kalahanis N Giannopoulos A Bakoyiannis C Bastounis E 《Surgery today》2005,35(10):841-845
Purpose Bile duct injury (BDI) represents the most serious complication of laparoscopic cholecystectomy (LC). The aim of this retrospective single-institution study was to evaluate the real incidence of BDI during laparoscopic and open cholecystectomy (OC) in a tertiary academic center in Athens, Greece.Methods Between January 1991 and December 2001, 3 637 patients underwent cholecystectomy in our department; as LC in 2 079 patients (LC group) and as OC in 1 558 patients (OC group). All the LCs were performed or supervised by five staff surgeons and all the OCs were performed or supervised by another five staff surgeons.Results There were 13 BDIs associated with LC (0.62%) and 6 associated with OC (0.38%) (P = 0.317). There was one death associated with BDI after LC. Only two (15.4%) of the BDIs associated with LC occurred within the proposed learning curve limit of 50 LCs per individual surgeon.Conclusion Laparoscopic cholecystectomy is safe and is not associated with a higher incidence of BDI than OC. Moreover, we did not find that the learning curve for LC affected BDI occurrence. 相似文献