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21.
A diaper bank and home visiting partnership: Initial exploration of research and policy questions
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Efficacy of parenteral antibiotics in the treatment of experimentally induced intraabdominal sepsis 总被引:1,自引:0,他引:1
An experimental model of intraabdominal sepsis closely approximating the disease in humans was used to evaluate the efficacy of clindamycin, tobramycin, cephalothin, and cefamandole, alone and in combination, in reducing both early mortality due to peritonitis and the subsequent development of abscesses. Sepsis was induced in rats by intraperitoneal placement of gelation capsules containing various amounts of human stool inoculum. Ninety percent of the untreated animals given a high inoculum died of peritonitis within 24 hr, and the survivors showed significant intraabdominal abscesses at the time of sacrifice. Animals treated with clindamycin-tobramycin, cephalothin-tobramycin, cefamandole-tobramycin, or cefamandole alone in the high-inoculum group showed a significant decrease in early mortality. Only animals treated with clindamycin-tobramycin, however, had a significantly increased cure rate (survival with no abscess present at time of sacrifice). In low-inoculum groups, several antibiotics alone or in combination significantly decreased mortality and increased cure rates. The selective use of antibiotics is critical in the treatment of severe forms of intraabdominal sepsis. 相似文献
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John Hogan Georges Samaha John Burke Kah Hoong Chang Eoghan Condon David Waldron John Calvin Coffey 《International surgery》2015,100(1):77-86
Twenty percent of colon cancers present as an emergency. However, the association between emergency presentation and disease-free survival (DFS) remains uncertain. Consecutive patients who underwent elective (CC) and emergent (eCC) resection for colon cancer were included in the analysis. Survival outcomes were compared between the 2 groups in univariate/multivariate analyses. A total of 439 patients underwent colonic resection for colon cancer during the interval 2000−2010; 97 (22.1%) presented as an emergency. eCC tumors were more often located at the splenic flexure (P = 0.017) and descending colon (P = 0.004). The eCC group displayed features of more advanced disease with a higher proportion of T4 (P = 0.009), N2 tumors (P < 0.01) and lymphovascular invasion (P< 0.01). eCC was associated with adverse locoregional recurrence (P = 0.02) and adverse DFS (P < 0.01 ) on univariate analysis. eCC remained an independent predictor of adverse locoregional recurrence (HR 1.86, 95% CI 1.50–3.30, P = 0.03) and DFS (HR 1.30, 95% CI 0.88–1.92, P = 0.05) on multivariate analysis. eCC was not associated with adverse overall survival and systemic recurrence. eCC is an independent predictor of adverse locoregional recurrence and DFS.Key words: Emergency presentation, Colon cancer, Disease free survival, Locoregional recurrenceColorectal cancer (CRC) is a significant cause of mortality, with over 40,000 new cases diagnosed annually in the UK contributing to over 16,000 deaths (Bowel Cancer UK).1,2 Up to 20% of colon cancers (CC) present as an emergency (eCC) necessitating emergent surgery.3,4 Although eCC has been shown to be associated with poorer overall survival (OS), much discrepancy exists in the literature regarding its association with disease-free survival (DFS).5−7Studies reporting the oncologic outcomes of CRC presenting as an emergency consist of heterogeneous populations of patients with colon and rectal cancers.3,5 Colon and rectal cancers are 2 distinct entities with different molecular, clinical, pathologic, and biologic characteristics and treatment modalities.8,4,9−11 Since the incorporation of combined multimodal treatment and total mesorectal excision the disparity in OS and DFS between colon and rectal cancer has increased.12−17 Rectal cancer patients may alter the impression of outcomes in emergency presenting colon cancer. Consequently, previous studies assessing outcomes in eCC may be flawed. Furthermore, the negative impact of eCC has previously been attributed to immediate postoperative complications with an inpatient hospital mortality of approximately 15%. Inclusion of such cases in studies assessing long-term outcomes may have overestimated the negative impact of eCC.18The aim of the current study was to determine the association between eCC and disease-free/overall survival. 相似文献
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Carla S. McWilliams Susan Condon Rebecca M. Schwartz Christine C. Ginocchio 《Journal of clinical microbiology》2014,52(7):2653-2655
The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or ≥1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBL-producing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates). 相似文献
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Impulse oscillometry measurement of distal airways obstruction in depleted uranium‐exposed Gulf War veterans
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Stella E. Hines MD MSPH Ashley H. Barnes BS Clayton Brown PhD Patricia Gucer PhD Marc S. Oliver RN MBA MPH Joanna M. Gaitens PhD MPH/MSN Marian Condon MSN Melissa McDiarmid MD MPH 《American journal of industrial medicine》2018,61(4):308-316
Introduction
A cohort of Gulf War I veterans who sustained exposure to depleted uranium undergoes biennial surveillance for potential uranium‐related health effects. We performed impulse oscillometry and hypothesized that veterans with higher uranium body burdens would have more obstructive abnormalities than those with lower burdens.Methods
We compared pulmonary function of veterans in high versus low urine uranium groups by evaluating spirometry and oscillometry values.Results
Overall mean spirometry and oscillometry resistance values fell within the normal ranges. There were no significant differences between the high and low uranium groups for any parameters. However, more veterans were classified as having obstruction by oscillometry (42%) than spirometry (8%).Conclusions
While oscillometry identified more veterans as obstructed, obstruction was not uranium‐related. However, the added sensitivity of this method implies a benefit in wider surveillance of exposed cohorts and holds promise in identifying abnormalities in areas of the lung historically described as silent.30.
Condon Amanda J. Hood Adam J. Willenborg Katie L. Kumfer Kraig Rose Anne E. 《Journal of thrombosis and thrombolysis》2020,50(1):195-200
Journal of Thrombosis and Thrombolysis - Heparin-induced thrombocytopenia (HIT) is a rare adverse drug reaction. The anti-PF4 antibody assay (ELISA) is utilized to assist in the clinical evaluation... 相似文献