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91.
Matthew E. Falagas Evridiki K. Vouloumanou Evagelia Baskouta Petros I. Rafailidis Kostantinos Polyzos Jordi Rello 《International journal of antimicrobial agents》2010,35(5):421-430
We evaluated the evidence regarding the effectiveness of various treatment strategies used for 2009 H1N1 influenza by reviewing available relevant studies. In total, 22 studies (15 cohort studies involving >10 patients, 5 cohort studies with ≤10 patients and 2 case reports) were included. A total of 3020 patients [1068 (35.4%) critically ill, 1722 (57.0%) hospitalised and 230 (7.6%) outpatients, including 909 (30.1%) children] were involved. Notably, 487 (16.1%) were obese [body mass index (BMI) >30)], 362 (12.0%) had asthma or chronic obstructive pulmonary disease and 255 (8.4%) were pregnant. Antiviral treatment was administered to 1622 patients (53.7%), of whom 661 (40.8%) received oseltamivir monotherapy. Corticosteroids were administered in 323 (31.8%) of 1016 patients for whom relevant data were available. Similarly, 633 (85.0%) of 745 patients received antibiotics. Comparative data from the largest included study (involving 1088 patients) indicated that administration of antivirals within 2 days from symptom onset was significantly associated with reduced mortality (P < 0.001). In summary, the scarcity of comparative available data hampered the establishment of any firm conclusions regarding the benefit that various treatment strategies may confer to patients with 2009 H1N1 influenza. Studies with a comparative design, as well as randomised studies are needed to clarify further this issue of major importance. 相似文献
92.
93.
Anxiety in patients undergoing MR imaging 总被引:6,自引:0,他引:6
To determine and quantify the major sources of anxiety for patients undergoing magnetic resonance (MR) imaging and to suggest means by which to eliminate or diminish their negative effects, the authors studied anxiety in 46 subjects. Of these, 20 randomly selected subjects who successfully completed the examination participated in exit interviews. Six subjects who terminated the examination before completion also completed exit interviews. Pre-imaging and postimaging questionnaires (state-trait anxiety inventory) were administered to measure anxiety in the 20 other subjects. Anxiety was associated with the constrictive dimensions of the magnet bore, examination duration, coil noise, and temperature within the bore. Preparation at the point of referral was consistently absent, incomplete, or misleading. Patients used identifiable strategies to cope with the examination: blinding, breathing relaxation techniques, visualization of pleasant images, and performance of mental exercises. 相似文献
94.
A. S. Michalopoulos S. Tsiodras K. Rellos S. Mentzelopoulos M. E. Falagas 《Clinical microbiology and infection》2005,11(2):115-121
A retrospective case series study was performed in a 30-bed general intensive care unit (ICU) of a tertiary care hospital to assess the effectiveness and safety of colistin in 43 critically ill patients with ICU-acquired infections caused by multiresistant Gram-negative bacteria. Various ICU-acquired infections, mainly pneumonia and bacteraemia caused by multiresistant strains of Pseudomonas aeruginosa and/or Acinetobacter baumannii, were treated with colistin. Good clinical response (cure or improvement) was noted in 74.4% of patients. Deterioration of renal function occurred in 18.6% of patients during colistin therapy. Nephrotoxicity was elevated significantly in those patients with a history of renal failure (62.5%). All-cause mortality amounted to 27.9%. In this group of critically ill patients, an age of >50 years (OR, 5.4; 95% CI 1.3-24.9) and acute renal failure (OR, 8.2; 95% CI 2.9-23.8) were independent predictors of mortality. Colistin should be considered as a treatment option in critically ill patients with infection caused by multiresistant Gram-negative bacilli. 相似文献
95.
Eleni Pitsouni Vangelis Alexiou Vasilis Saridakis George Peppas Matthew E. Falagas 《European journal of clinical pharmacology》2009,65(6):561-570
Background Advances in surgery have considerably lowered postoperative morbidity. However, infection remains a considerable morbidity
factor. The aim of this review is to identify the potential benefit(s) of the perioperative administration of probiotics/synbiotics
to patients undergoing abdominal surgery.
Methods We searched PubMed, Scopus, Web of Science, and Cochrane library to identify randomized controlled trials (RCTs) that studied
the perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery.
Results Nine RCTs studying 733 patients were included in our review. The incidence of postoperative pneumonia, cholangitis, and any
infections as well as the duration of postoperative hospital stay and length of antibiotic therapy were lower among patients
receiving probiotics than in the control group [six RCTs, 355 patients, odds ratio (OR) 0.24, 95% confidence interval (CI)
0.09–0.68; three RCTs, 209 patients, OR 0.18, 95% CI 0.05–0.57; seven RCTs, 514 patients, OR 0.26, 95% CI 0.12–0.55; five
RCTs, 313 patients, OR −2.70, 95% CI −5.15 to −0.25; four RCTs, 250 patients, OR −4.01, 95% CI −5.11 to −2.92, respectively],
while the incidence of postoperative wound infection, urinary tract infection, intra-abdominal abscess, and mortality was
not different between patients of the compared groups (six RCTs, 355 patients, OR 0.52, 95% CI 0.23–1.18; five RCTs, 313 patients,
OR 0.44, 95% CI 0.04–5.54; four RCTs, 226 patients, OR 0.44, 95% CI 0.12–1.59; nine RCTs, 685 patients, OR 0.98, 95% CI 0.29–3.29,
respectively).
Conclusion The use of probiotics/synbiotics may reduce postoperative infections after abdominal surgery. This is a promising infection-preventive
measure that may decrease morbidity, length of antibiotic therapy, duration of hospital stay, and pressure for emergence of
antimicrobial resistance. However, the results of this meta-analysis should be interpreted with caution due to the significant
heterogeneity of the studies included. 相似文献
96.
Di Chiro G; Girton ME; Frank JA; Dietz MJ; Gansow OA; Wright DC; Dwyer AJ 《Radiology》1986,160(1):221-222
Canine cerebrospinal fluid rhinorrhea, which occurs frequently in purebred beagles, was demonstrated in two dogs on magnetic resonance images after cisternal introduction of gadolinium-DTPA dimeglumine. 相似文献
97.
Chest radiographs were compared for three groups of children 8-9 years old: 23 survivors of bronchopulmonary dysplasia (BPD), 33 survivors of hyaline membrane disease without BPD, and 35 survivors of premature birth without neonatal respiratory problems. Only four children in the second group and three in the third had abnormal lungs. Linear shadows, apparently representing strands of fibrosis or deep pleural fissuring, were seen more frequently (15 of 23) in the BPD group than in the others (P less than .0001). Seventeen children in the BPD group had definite pulmonary abnormalities, none of them severe. The anteroposterior dimension of the chest in survivors of BPD tended to be decreased (P less than .001 vs that of reported control subjects). 相似文献
98.
Dr James H. Philip ME MD Daniel B. Raemer PhD 《Journal of clinical monitoring and computing》1986,2(3):151-154
A prototype electronic monitoring stethoscope was constructed from readily available, high-quality components. It consisted of a conventional precordial or esophageal probe connected to a microphone by a rubber adapter. The microphone was connected by lightweight wire to an amplifier and headphones. Twenty-one anesthesia clinicians evaluated the stethoscope and responded to a multiple-choice preference questionnaire. The electronic stethoscope was judged to perform better than the conventional stethoscope in most categories evaluated. The electronic device was perceived to be louder, clearer in sound reproduction, more efficacious for monitoring, and easier to use continuously, and its head-phones were considered more comfortable than the conventional carpiece. Based on our results, we conclude that amplified stethoscopes have the potential to improve monitoring. Further development of electronic stethoscope monitoring seems warranted and is continuing. 相似文献
99.
WILLIAMS PS; STEVENS ME; FASS G; IRONS L; BONE JM 《QJM : monthly journal of the Association of Physicians》1991,81(1):837-855
SUMMARY Ninety-five patients (63 male, 32 female), age 45±2 years(mean±SEM) with chronic renal failure of varied aetiologywere randomized to receive either a conventional low proteindiet (0.6 g/kg/day protein, 800 mg phosphate; n=33), a low phosphatediet (providing approximately 1000 mg phosphate plus an orallyadministered phosphate binder, minimum protein intake 0.8 g/kg/day;n=30) or to control (minimum protein intake 0.8 g/kg/day, nophosphate restriction; n=32). Patients were reviewed for a minimumof 6 months before randomization and were withdrawn from thestudy if plasma creatinine exceeded 900 µmol/1, plasmaphosphate was > 2.0 mmol/1 or at the onset of uraemic symptoms. Following randomization patients were studied for an averageof 19±3 months. Mean plasma creatinine rose from 398±33to 600±50 µmol/1. Dietary protein intake was estimatedat 0.69±0.02 g/kg/day in the low protein group, 1.02±0.05in the low phosphate and 1.14±0.05 in the controls, phosphateintake was 815±43, 1000± 47, and 1315±57mg/day, respectively. Urinary urea excretion and protein catabolicrates were significantly reduced (p<0.01) only in those onprotein restriction, at 213±9 mmol/24 hours and 0.71g/kg/day, respectively. Phosphate excretion was significantlylower (p<0.05) in both the low protein group (17.9±0.8mmol/24 hours) and the low phosphate group (18.6±1.0mmol/24 hours) compared to controls. Changes in body weight,muscle mass and serum transferrin, albumin and immunoglobulinswere comparable between the groups. Mean blood pressure followingrandomization was 150/89±3/1 (low protein), 148/87±3/1(low phosphate) and 146/87±3/1 (controls). Progression of renal failure was analysed by rate of fall ofcreatinine clearance (ml/min/ 1.73 m2/month), by rate of deteriorationderived from reciprocal plasma creatinine against time plots(1/mmol/year) and to assess individual patient's response totreatment by two phase linear regression (breakpoint)analysis of reciprocal plasma creatinine/time plots. Progressionwas analysed only in patients seen for at least 3 months followingrandomization. The rate of fall of creatinine clearance was not significantlydifferent between the groups (ANOVA): 0.56±0.08 ml/min/1.73m2/month (low protein, n=28), 0.44±0.07 (low phosphate,n=23) and 0.69±0.11 (control, n=27). In 50 patients (18low protein, 16 low phosphate and 16 control) whose rate ofprogression could be calculated before and after randomization,there was a fall in rate of progression averaging 0.18 ml/min/1.73m2/month in those on low protein diet and those on low phosphatediet, but a rise of 0.08 in the controls. These differenceswere, however, not statistically significant. Similar resultswere obtained when the rates of deterioration were calculatedfrom plasma creatinine. Significant individual improvements(p<0.01) in rates of progression by breakpointanalysis occurred in 17 patients: six on low protein, sevenon low phosphate and in four controls. Sixty-one (72 per cent)of the patients examined by this method showed no significantchange in the rate of progression while seven patients had acceleratedprogression. There was no difference in the requirement formaintenance dialysis facilities between groups. No significant benefit of protein and phosphate restrictionwas therefore demonstrated. 相似文献
100.
ME Lenaerts 《Cephalalgia : an international journal of headache》2008,28(S1):12-15
The ICHD-II criteria for post-traumatic headache (PTH) are strictly outlined. PTH can be subdivided into an acute and a chronic forms, the former likely nociceptive in nature, the latter likely neuropathic. The time of transition between the acute and the chronic forms is artificial and in the future should be better based on clear clinical or rather biological data. Chronic PTH often presents as one of the primary headache syndromes, e.g. migraine or tension-type headache. Its biology is poorly understood and whether it merely represents the expression of the primary headache or it has a distinct pathogenesis remains unclear. The frontal lobe is often affected in traumatic head injury. Its dysfunction can cause an array of clinical consequences that have an impact on the patient's symptomatology and therapeutic outcome. Its recognition is likely to improve patient management quality. 相似文献