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91.
Vouloumanou EK Karageorgopoulos DE Rafailidis PI Michalopoulos A Falagas ME 《International journal of antimicrobial agents》2011,38(3):197-216
Emergence of resistance to widely used trimethoprim/sulfamethoxazole (TMP/SMX) as well as common adverse events in human immunodeficiency virus (HIV)-infected patients casts interest on combinations of TMP with other sulfonamides. Sulfametrole (SMT) combined with TMP could provide a choice for difficult-to-treat infections, particularly when administered intravenously. The objective of this review was to evaluate the available clinical and pharmacokinetic/pharmacodynamic (PK/PD) evidence regarding TMP/SMT, particularly in comparison with TMP/SMX. We reviewed the available evidence retrieved from searches in PubMed/Scopus/Google Scholar and by bibliography hand-searching. In total, 46 eligible studies (most published before 1997) were identified, 7 regarding intravenous (i.v.) TMP/SMT, 24 regarding oral TMP/SMT and 15 providing comparative data for TMP/SMT versus TMP/SMX. The antimicrobial activity of TMP/SMT was similar to TMP/SMX for Gram-positive isolates. A greater percentage of Escherichia coli and Proteus spp. isolates were susceptible to TMP/SMT compared with TMP/SMX. PK/PD data suggest a dosage adjustment of i.v. TMP/SMT in patients with seriously impaired renal function. Four randomised controlled trials and 16 non-comparative studies reported good effectiveness/safety outcomes for oral TMP/SMT in genital ulcers (mainly chancroid), respiratory tract infections and urinary tract infections (UTIs). Moreover, i.v. TMP/SMT was effective against Pneumocystis jiroveci infection in HIV-infected patients, severe pneumonia and UTIs. In one study, hypersensitivity reactions occurred in 18/52 (34.6%) of HIV-infected patients; 2/52 (3.8%) developed psychosis. Gastrointestinal adverse events were mild and rare. Excipients in i.v. TMP/SMT formulations might be less toxic compared with i.v. TMP/SMX formulations, particularly for children. In conclusion, despite the scarcity of contemporary evidence, available data suggest that TMP/SMT could be an alternative treatment option to TMP/SMX, even in serious infections, when administered intravenously. 相似文献
92.
Vardavas CI Patelarou E Grandér M Chatzi L Palm B Fthenou E Roumeliotaki T Koutis A Kafatos A Vrijheid M Connolly GN Murphy S Vahter M Kogevinas M 《Xenobiotica; the fate of foreign compounds in biological systems》2011,41(6):456-463
Exposure to toxic metals during pregnancy may have detrimental effects on foetal development. We assessed the role of sociodemographic characteristics and active and passive smoking on blood concentrations of metals (As, Cd, Pb, Hg, Sb, U, Mn and Mo). Venous blood drawn from 50 pregnant women, randomly selected from the mother-child birth cohort 'Rhea'. Extensive questionnaire data on active and passive smoking were collected. Urinary cotinine was measured to validate self-reported exposure and non-smoking status. Smokers had higher concentrations of Cd (1.0 μg/L) as compared with non-smokers (0.29 μg/L, P?0.001) and a tendency for higher As and Hg. Among non-smokers, blood As and Hg concentrations were also associated with exposure to passive smoking in public venues and the family home and to overall greater secondhand smoke (SHS) exposure (As: 0.97μg/L among heavy-exposed compared with 0.20 μg/L among the low-exposed, P?0.05; Hg: 2.1 μg/L vs. 0.9 μg/L respectively, P?0.05). Controlling for fish and seafood intake altered the statistical significance but not the direction of the above associations. Smoking was associated with higher Cd concentrations in pregnant women, although the association between passive smoking and elevated As and Hg concentrations was indicative, however inconclusive. 相似文献
93.
Giakoumidakis K Baltopoulos GI Charitos C Patelarou E Galanis P Brokalaki H 《Nursing in critical care》2011,16(5):243-251
Aims and objectives: To identify the factors that might affect the length of stay in the intensive care unit (ICU‐LOS) among cardiac surgery patients. Background: ICU‐LOS forms an important factor for assessing the effectiveness of the provided nursing care. A number of factors can be accused for increasing patient hospitalization. The nursing workload (NWL), among others, was found to play a significant role as it is closely associated with the quality of care. Design: An observational cohort study among 313 consecutive patients who were admitted to the cardiac surgery intensive care unit of a general, tertiary hospital of Athens, Greece from November 2008 to November 2009. Methods: Data collection was performed by using a short questionnaire (for basic demographic information) and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE, for assessing the NWL and the perioperative risk for each patient respectively. Results: ICU‐LOS of more than 2 days increased with age and was more common among females (p < 0·001 and p = 0·02, respectively). Multivariate logistic regression analysis revealed a positive association between increased perioperative risk and the increased ICU‐LOS [odd ratio (OR) 1·9, 95% confidence interval (CI) 1·0–3·5, p = 0·04], while patients with a first day NAS of more than 61·6% had an almost 5·2 times greater probability to stay in the cardiac surgery unit for more than 2 days (OR 5·2, 95% CI 3·0–8·8, p < 0·001). Conclusions: Increased level of NWL and patient perioperative risk are closely associated with increased ICU‐LOS. Relevance to clinical practice: The correlation between patient perioperative risk and ICU‐LOS encourages the early identification of high‐risk patients for prolonged hospitalization. Furthermore, the relationship between NWL and ICU‐LOS allows the early identification of these patients with the use of an independent nursing tool. 相似文献
94.
Standard Precautions have been introduced as a means to protect health professionals from exposure to pathogens. This study examines the extent of Cypriot nurses' compliance with the main aspects of Standard Precautions and explores the possible associations with the nurses' characteristics. Self-completed questionnaires that examined the frequency of the implementation of Standard Precautions were distributed to a convenience sample of 668 nurses.The response rate was 89.37%.The results showed inadequate compliance with Standard Precautions. Full compliance with all the main aspects of Standard Precautions was reported by only 9.1% of the participants. Male nurses and those who had not been exposed previously to pathogens reported better compliance, in comparison to female nurses and those who had been exposed previously. Nurses who had participated previously in an educational program about Standard Precautions reported a higher frequency of implementing them than those who had not participated. The nurses' age and frequency of the implementation of Standard Precautions were found to be significantly and positively correlated. The results can be used to enhance nurses' safety by focusing on areas of non-compliance. 相似文献
95.
Hanssa Summah ZHU Ying-gang Matthew E Falagas Evridiki K Vouloumanou QU Jie-ming 《中华医学杂志(英文版)》2013,126(10):1965-1973
Background The diagnosis of Pneumocystis pneumonia (PCP) in immunocompromised patients is still challenging today due to the absence of an in vitro culture system and the low diagnostic accuracy of mic... 相似文献
96.
Efstathios Kastritis Maria Roussou Michalis Michael Maria Gavriatopoulou Evridiki Michalis Magdalini Migkou Sossana Delimpasi Marie Christine Kyrtsonis Dimitrios Gogos Konstantinos Liapis Evangelia Charitaki Panagiotis Repousis Evangelos Terpos Meletios A. Dimopoulos On behalf of the Greek Myeloma Study Group 《British journal of haematology》2010,150(5):587-591
Serum levels of five angiogenic cytokines were evaluated in 82 patients with primary systemic amyloidosis (AL). Angiopoietin‐1, vascular endothelial growth factor, basic fibroblast growth factor and angiogenin were higher in AL patients than in controls (n = 35) and newly‐diagnosed, symptomatic, myeloma patients (n = 35). Angiopoetin‐1/Angiopoetin‐2 ratio was lower in AL compared to controls but higher than in myeloma patients. Angiopoetin‐2 correlated with cardiac dysfunction indices; however, none of the angiogenic growth factors was prognostically significant. The increased angiogenic cytokine levels observed in AL seem to represent either a toxic effect of amyloid fibrils or light chains, or a compensatory response to organ dysfunction. 相似文献
97.
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99.
Pavlos?SarafisEmail author Eirini?Rousaki Andreas?Tsounis Maria?Malliarou Liana?Lahana Panagiotis?Bamidis Dimitris?Niakas Evridiki?Papastavrou 《BMC nursing》2016,15(1):56
Background
Nursing is perceived as a strenuous job. Although past research has documented that stress influences nurses’ health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied. The aim was to investigate and explore the correlation amidst occupational stress, caring behaviors and their quality of life in association to health.Methods
A correlational study of nurses (N?=?246) who worked at public and private units was conducted in 2013 in Greece. The variables were operationalized using three research instruments: (1) the Expanded Nursing Stress Scale (ENSS), (2) the Health Survey SF-12 and (3) the Caring Behaviors Inventory (CBI). Univariate and multivariate analyses were performed.Results
Contact with death, patients and their families, conflicts with supervisors and uncertainty about the therapeutic effect caused significantly higher stress among participants. A significant negative correlation was observed amidst total stress and the four dimensions of CBI. Certain stress factors were significant and independent predictors of each CBI dimension. Conflicts with co-workers was revealed as an independent predicting factor for affirmation of human presence, professional knowledge and skills and patient respectfulness dimensions, conflicts with doctors for respect for patient, while conflicts with supervisors and uncertainty concerning treatment dimensions were an independent predictor for positive connectedness. Finally, discrimination stress factor was revealed as an independent predictor of quality of life related to physical health, while stress resulting from conflicts with supervisors was independently associated with mental health.Conclusion
Occupational stress affects nurses’ health-related quality of life negatively, while it can also be considered as an influence on patient outcomes.100.