Infective endocarditis in diabetic and non-diabetic patients

We compared clinical, microbiological, and prognostic characteristics of infective endocarditis in patients with and without diabetes mellitus. In 1987--1996, 213 patients with definite or possible infective endocarditis were included, of which 39 (18%) had diabetes mellitus. Diabetic patients were older than non-diabetic (median age of 71 vs 65 y, respectively; p =0.04), had more aortic valve and less mitral valve involvement (71% vs 27%, and 21% vs 62%; p = 0.004). There was no significant difference in the frequency of Staphylococcus aureus involvement between the 2 groups (21% in diabetic vs 20% in non-diabetic group; p = ns). On multivariate analysis diabetes mellitus was not found to be an independent factor for mortality. Unlike other infections diabetes mellitus does not significantly affect clinical and microbiological features, and outcome of infective endocarditis.     

Exhaled nitric oxide is age-dependent in asthma

We determined whether the exhaled nitric oxide (eNO) level in asthmatics is age-dependent. Eighty-seven asthmatic patients aged 2-41 years were studied. Hyperreactivity to adenosine 5'-monophosphate (AMP) was used to confirm asthma (相似文献   

Risk factors for enterococcal urinary tract infections: a multinational,retrospective cohort study

European Journal of Clinical Microbiology & Infectious Diseases - Complicated urinary tract infection (cUTI) is a frequent cause of morbidity. In this multinational retrospective cohort study,...     

Therapieergebnisse der Stapler-H?morrhoidopexie versus der H?morrhoidenarterienligatur bei H?morrhoiden 3.?Grades

Purpose

The aim of the study was to evaluate the long-term results, early and late complication rates and overall satisfaction of patients with grade III hemorrhoids treated by stapled hemorrhoidopexy (SH) or doppler-guided hemorrhoidal artery ligation (DGHAL).

Methods

Operative and follow-up patient data were prospectively collected for patients undergoing either SH or DGHAL by a single surgeon during a 2-year period. A retrospective comparison between patient outcomes after operations by one of the two methods was made based on these data. Clinical data on postoperative pain, analgesic requirements, time to first bowel movement and functional recovery were collected at five postoperative follow-up visits (1 and 6 weeks, 6, 12, and 18 months). Data on patient satisfaction, recurrence of hemorrhoidal symptoms and further treatment were obtained from a standardized questionnaire completed during the last visit 18 months postoperatively.

Results

A total of 63 patients underwent SH (average age 52?±?3.2 years) and 51 patients underwent DGHAL (average age 50?±?7.3 years). The DGHAL patients experienced less postoperative pain as scored by pain during bowel movement (2.1?±?1.4 vs. 5.5?±?1.9 for SH), and required less postoperative analgesics. Hospital stay, time to first bowel movement and complete functional recovery were also significantly shorter for the DGHAL patients. A total of 9 DGHAL patients (18%) suffered from persistent bleeding or prolapse and required additional treatment compared with 2 (3%) patients in the SH group. The SH patients reported greater satisfaction compared with DGHAL patients at 1 year postoperatively.

Conclusions

Both SH and DGHAL are safe procedures and have similar effectiveness for treating grade III hemorrhoid;s however DGHAL is less painful and provides earlier functional recovery but is associated with higher recurrence rates and lower satisfaction rates compared with SH.     

Is the diagnostic yield of prostate needle biopsies affected by prostate volume?

ObjectivesTo determine the effect of prostate volume on the diagnostic yield of prostate biopsies.Materials and methods155 consecutive patients underwent 12-core transrectal ultrasound guided needle biopsies. Data were collected prospectively on age, serum PSA, digital rectal examination (DRE), previous prostate biopsies, prostate volume and pathologic result. Univariate and multivariate logistic regressions were undertaken to determine the effect of prostate volume on the risk for a positive biopsy.Results45 patients (29%) were diagnosed with cancer. The median patient age was 63 (range 48–82) years, the median PSA level was 6.7 ng/ml (0.5–156 ng/ml), and the median prostate volume was 57 ml (16–273 ml). 42 patients (27%) had an abnormal DRE and 51 (33%) had undergone previous prostate biopsies. Positive biopsy rates were 39%, 33%, and 14% for prostate volume below 46 ml, between 45 and 73 ml, and above 72 ml, respectively. Univariate analysis showed that age, serum PSA, DRE and prostate volume were all associated with a positive biopsy. Multivariate analysis adjusted for age, PSA and DRE showed a significant risk increase for a positive biopsy in smaller prostates. (OR = 5.6 95% CI 1.75–17.89; and 8.86 95% CI 2.72–28.82, for prostate volume between 45 and 72 ml and below 45 ml, respectively).ConclusionThe diagnostic yield of prostate biopsies is significantly lower in large prostates. As the result the standard 12-core biopsy may be insufficient for the diagnosis of cancer in large prostates.     

Direct Transfer to a Tertiary Care Hospital After Traumatic Injury is Associated with a Survival Benefit in a Resource-Limited Setting

World Journal of Surgery - Trauma is a leading cause of morbidity and mortality worldwide, and patients in low- and middle-income countries are disproportionately affected. Organized trauma...     

The effect of colonoscopy on intraocular pressure: an observational prospective study

Graefe's Archive for Clinical and Experimental Ophthalmology - Colonoscopy is an endoscopic examination of the bowel. It requires insufflation of the large bowel lumen with gas which leads to...