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81.
Virk Sohrab S. Diwan Ashish Phillips Frank M. Sandhu Harvinder Khan Safdar N. 《Clinical orthopaedics and related research》2017,475(11):2752-2762
Clinical Orthopaedics and Related Research® - Lumbar discectomy has been shown to be clinically beneficial in numerous studies for appropriately selected patients. Some patients, however,... 相似文献
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Yao‐Wen Cheng Emmalee Phelps Vincent Ganapini Noor Khan Fangqian Ouyang Huiping Xu Sahil Khanna Raseen Tariq Rachel J. Friedman‐Moraco Michael H. Woodworth Tanvi Dhere Colleen S. Kraft Dina Kao Justin Smith Lien Le Najwa El‐Nachef Nirmal Kaur Sree Kowsika Adam Ehrlich Michael Smith Nasia Safdar Elizabeth Ann Misch Jessica R. Allegretti Ann Flynn Zain Kassam Asif Sharfuddin Raj Vuppalanchi Monika Fischer 《American journal of transplantation》2019,19(2):501-511
Fecal microbiota transplant (FMT) is recommended for Clostridium difficile infection (CDI) treatment; however, use in solid organ transplantation (SOT) patients has theoretical safety concerns. This multicenter, retrospective study evaluated FMT safety, effectiveness, and risk factors for failure in SOT patients. Primary cure and overall cure were defined as resolution of diarrhea or negative C difficile stool test after a single FMT or after subsequent FMT(s) ± anti‐CDI antibiotics, respectively. Ninety‐four SOT patients underwent FMT, 78% for recurrent CDI and 22% for severe or fulminant CDI. FMT‐related adverse events (AE) occurred in 22.3% of cases, mainly comprising self‐limiting conditions including nausea, abdominal pain, and FMT‐related diarrhea. Severe AEs occurred in 3.2% of cases, with no FMT‐related bacteremia. After FMT, 25% of patients with underlying inflammatory bowel disease had worsening disease activity, while 14% of cytomegalovirus‐seropositive patients had reactivation. At 3 months, primary cure was 58.7%, while overall cure was 91.3%. Predictors of failing a single FMT included inpatient status, severe and fulminant CDI, presence of pseudomembranous colitis, and use of non‐CDI antibiotics at the time of FMT. These data suggest FMT is safe in SOT patients. However, repeated FMT(s) or additional antibiotics may be needed to optimize rates of cure with FMT. 相似文献
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Monachese M Cunningham-Rundles S Diaz MA Guerrant R Hummelen R Kemperman R Kerac M Kort R Merenstein D Panigrahi P Ramakrishna B Safdar N Shane A Trois L Reid G 《Gut microbes》2011,2(3):198-207
Infectious disease in the developing world continues to represent one of the greatest challenges facing humanity. Every year over a million children suffer and die from the sequela of enteric infections, while in 2008 it is estimated almost 2.7 million (UNAIDS 2009 update) adults and children became infected with human immunodeficiency virus (HIV). While oral rehydration therapy for diarrhea, and antiretrovirals (ARV) for HIV are critical, there is a place for adjunctive therapies to improve quality of life. The importance of the human microbiota in retaining health is now recognized, as is the concept of replenishing beneficial microbes through probiotic treatments. Studies have shown that probiotics can reduce the duration of diarrhea, improve gut barrier function, help prevent bacterial vaginosis (BV), and enhance immunity even in HIV-infected subjects. However, many issues remain before the extent of probiotic benefits can be verified, and their application to the developing world realised. This consensus report outlines the potential probiotic, and to a lesser extent prebiotic, applications in resource disadvantages settings, and recommends steps that could bring tangible relief to millions of people. The challenges to both efficacy and effectiveness studies in these settings include a lack of infrastructure and funding for scientists, students and research projects in developing countries; making available clinically proven probiotic and prebiotic products at affordable prices; and undertaking appropriately designed clinical trials. We present a roadmap on how efficacy studies may be conducted in a resource disadvantages setting among persons with chronic diarrhea and HIV. These examples and the translation of efficacy into effectiveness are described. 相似文献
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We report a case of complete bilateral cerebellar infarction diagnosed in utero by routine prenatal ultrasound and magnetic resonance imaging in a 26-week-old fetus. This posterior fossa ischemic stroke with secondary hemorrhage caused transient obstructive hydrocephalus and likely occurred subsequent to vertebrobasilar artery thrombosis. Such posterior fossa ischemic insults diagnosed in utero are rare with scarce clinical reports. The serial imaging characteristics, clinical, and developmental implications of this case are reviewed. 相似文献
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