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71.
72.
Mathai E Rolain JM Verghese L Mathai M Jasper P Verghese G Raoult D 《Transactions of the Royal Society of Tropical Medicine and Hygiene》2003,97(5):570-572
Scrub typhus, caused by Orientia tsutsugamushi, is a rural zoonosis endemic in the Asian Pacific region. Doxycycline and chloramphenicol, the recommended drugs for treating this infection, may not be safe during pregnancy. We report on 5 patients with scrub typhus during pregnancy who were seen in India between October 2001 and February 2002. Four of the 5 women were treated initially with ciprofloxacin. Three women had stillbirths, 1 an abortion and 1 a low birthweight baby, which suggests that ciprofloxacin should not be used for treating pregnant women and that scrub typhus leads to severe adverse effects during pregnancy. Randomized controlled trials are urgently needed to ascertain the optimal drug choice, given that currently recommended drugs are contraindicated in pregnant women. 相似文献
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Verghese SL Padmaja P Sutha P Mathew T Johni ES 《Indian journal of pathology & microbiology》2001,44(3):305-307
All though extremely rare 10 years ago, antifungal drug resistance is becoming a major problem in certain populations, especially in those infected with HIV. This study was undertaken to study the resistance of Candida species isolated in our hospital to Fluconazole using Chrom agar Candida. The Candida strains which were routinely isolated from clinical specimens like blood, urine, sputum, pus, fluid and homograft isolates were included in the study. 142 Candida isolates were tested by using Chrom agar Candida incorporated with Fluconazole. 16 strains were found to be resistant to Fluconazole and 126 strains sensitive to Fluconazole. Nine were C. tropicalis, 3 C. krusei, 2 C. guillermondii, 1 Geotrichum candidum and one was an unidentified strain of Candida. The MIC of the 16 strains were done using RPMI 1640 medium by macro broth dilution method. MIC of 9 strains was 64 & > 64 ug/ml of 6 strains 32 ug/ml and 1 strain 16 ug/ml. 相似文献
76.
Ketamine and midazolam is an inappropriate preinduction combination in uncooperative children undergoing brief ambulatory procedures 总被引:1,自引:0,他引:1
BACKGROUND: We prospectively studied the effects of intramuscular (i.m.) ketamine alone, or combined with midazolam, on mask acceptance and recovery in young children who were uncooperative during induction of anaesthesia. METHODS: The Institutional Review Board (IRB) approval was obtained to study 80 children, 1-3 years, scheduled for bilateral myringotomies and tube insertion (BMT). Mask induction was attempted in all the children. Those who were uncooperative were randomly assigned to one of the four preinduction treatment groups: group I, ketamine 2 mg.kg(-1); group II, ketamine 2 mg.kg(-1) combined with midazolam 0.1 mg.kg(-1); group III, ketamine 2 mg.kg(-1) with midazolam 0.2 mg.kg(-1); or group IV, ketamine 1 mg.kg(-1) with midazolam 0.2 mg.kg(-1). Anaesthesia was continued with nitrous oxide and halothane by facemask. RESULTS: Children in all treatment groups achieved satisfactory sedation in less than 3 min following the administration of the preinduction drug(s). Compared with patients who received halothane induction (comparison group), the use of ketamine alone did not significantly (P > 0.0167, a Bonferroni corrected significance level) delay recovery and discharge times (18.8 +/- 2.5 and 82.5 +/- 30.7 min vs 12.6 +/- 4.6 and 81.0 +/- 33.8 min, P = 0.030 and P = 0.941, respectively). Patients who received ketamine/midazolam combinations, however, had significantly longer recovery and discharge times vs halothane (32.3 +/- 14.0 and 128.0 +/- 36.6 min, P = 0.001, P = 0.007, respectively). These times were so clinically unacceptable, that the study had to be terminated with only 17 patients receiving study drugs. CONCLUSIONS: It is concluded that ketamine/midazolam combination is not appropriate for preinduction of anaesthesia in paediatric ambulatory patients because of unacceptably prolonged recovery and delayed discharge times. 相似文献
77.
Cryopreservation of cardiac homografts 总被引:4,自引:0,他引:4
Verghese S Sudha P Padmaja P Mathew T Prabhakar P Arumugam SB Murthy KS Cherian KM 《Indian heart journal》1999,51(3):301-306
A homograft valve bank for cryopreservation of cardiac homografts was established at the Institute of Cardiovascular Diseases in July 1995. From July 1995 to February 1999, 169 donor hearts were processed. All except four hearts were procured post mortem. Aortic valves (149) and pulmonary valves (139) were the common homografts dissected out for use. The valves were immersed in a cocktail of five broad spectrum antibiotics and antifungals for an average of 48 to 72 hours before cryopreservation. Fifty-three (35.57%) aortic and 42 (30.21%) pulmonary valves had to be discarded for various reasons like fungal contamination, failure to sterilise, HBsAg positivity etc.; 153 homografts have been released for use so far. Analysing the usual methods of procurement, sterilisation protocol, culture and cryopreservation used for cardiac homografts at this centre, this paper recommends observance of timeliness, use of appropriate media for preservation of heart parts, administration of specific drugs and safeguards necessary for cryopreservation procedure. 相似文献
78.
79.
Xu-Feng Zhang Fabio Bagante Qinyu Chen Eliza W. Beal Yi Lv Matthew Weiss Irinel Popescu Hugo P. Marques Luca Aldrighetti Shishir K. Maithel Carlo Pulitano Todd W. Bauer Feng Shen George A. Poultsides Olivier Soubrane Guillaume Martel B. Groot Koerkamp Alfredo Guglielmi Timothy M. Pawlik 《Surgery》2018,163(5):1114-1120
Background
Intrahepatic cholangiocarcinoma with hepatic hilus involvement has been either classified as intrahepatic cholangiocarcinoma or hilar cholangiocarcinoma. The present study aimed to investigate the clinicopathologic characteristics and short- and long-term outcomes after curative resection for hilar type intrahepatic cholangiocarcinoma in comparison with peripheral intrahepatic cholangiocarcinoma and hilar cholangiocarcinoma.Methods
A total of 912 patients with mass-forming peripheral intrahepatic cholangiocarcinoma, 101 patients with hilar type intrahepatic cholangiocarcinoma, and 159 patients with hilar cholangiocarcinoma undergoing curative resection from 2000 to 2015 were included from two multi-institutional databases. Clinicopathologic characteristics and short- and long-term outcomes were compared among the 3 groups.Results
Patients with hilar type intrahepatic cholangiocarcinoma had more aggressive tumor characteristics (eg, higher frequency of vascular invasion and lymph nodes metastasis) and experienced more extensive resections in comparison with either peripheral intrahepatic cholangiocarcinoma or hilar cholangiocarcinoma patients. The odds of lymphadenectomy and R0 resection rate among patients with hilar type intrahepatic cholangiocarcinoma were comparable with hilar cholangiocarcinoma patients, but higher than peripheral intrahepatic cholangiocarcinoma patients (lymphadenectomy incidence, 85.1% vs 42.5%, P?<?.001; R0 rate, 75.2% vs 88.8%, P?<?.001). After curative surgery, patients with hilar type intrahepatic cholangiocarcinoma experienced a higher rate of technical-related complications compared with peripheral intrahepatic cholangiocarcinoma patients. Of note, hilar type intrahepatic cholangiocarcinoma was associated with worse disease-specific survival and recurrence-free survival after curative resection versus peripheral intrahepatic cholangiocarcinoma (median disease-specific survival, 26.0 vs 54.0 months, P?<?.001; median recurrence-free survival, 13.0 vs 18.0 months, P?=?.021) and hilar cholangiocarcinoma (median disease-specific survival, 26.0 vs 49.0 months, P?=?.003; median recurrence-free survival, 13.0 vs 33.4 months, P?<?.001).Conclusion
Mass-forming intrahepatic cholangiocarcinoma with hepatic hilus involvement is a more aggressive type of cholangiocarcinoma, which showed distinct clinicopathologic characteristics, worse long-term outcomes after curative resection, in comparison with peripheral intrahepatic cholangiocarcinoma and hilar cholangiocarcinoma. 相似文献80.
Kazunari Sasaki Georgios A. Margonis Nikolaos Andreatos Fabio Bagante Matthew Weiss Carlotta Barbon Irinel Popescu Hugo P. Marques Luca Aldrighetti Shishir K. Maithel Carlo Pulitano Todd W. Bauer Feng Shen George A. Poultsides Oliver Soubrane Guillaume Martel B Groot Koerkamp Alfredo Guglielmi Timothy M. Pawlik 《Journal of the American College of Surgeons》2018,226(4):393-403