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991.
Nicolò Girometti Russell E. Lewis Maddalena Giannella Simone Ambretti Michele Bartoletti Sara Tedeschi Fabio Tumietto Francesco Cristini Filippo Trapani Paolo Gaibani Pierluigi Viale 《Medicine》2014,93(17)
Multidrug resistance associated with extended-spectrum beta-lactamase (ESBL) and Klebsiella pneumoniae carbapenemase (KPC) among K. pneumoniae is endemic in southern Europe. We retrospectively analyzed the impact of resistance on the appropriateness of empirical therapy and treatment outcomes of K. pneumoniae bloodstream infections (BSIs) during a 2-year period at a 1420-bed tertiary-care teaching hospital in northern Italy. We identified 217 unique patient BSIs, including 92 (42%) KPC-positive, 49 (23%) ESBL-positive, and 1 (0.5%) metallo-beta-lactamase-positive isolates. Adequate empirical therapy was administered in 74% of infections caused by non-ESBL non-KPC strains, versus 33% of ESBL and 23% of KPC cases (p < 0.0001). To clarify the impact of resistance on BSI treatment outcomes, we compared several different models comprised of non-antibiotic treatment-related factors predictive of patients’ 30-day survival status. Acute Physiology and Chronic Health Evaluation (APACHE) II score determined at the time of positive blood culture was superior to other investigated models, correctly predicting survival status in 83% of the study cohort. In multivariate analysis accounting for APACHE II, receipt of inadequate empirical therapy was associated with nearly a twofold higher rate of death (adjusted hazard ratio 1.9, 95% confidence interval 1.1–3.4; p = 0.02). Multidrug-resistant K. pneumoniae accounted for two-thirds of all K. pneumoniae BSIs, high rates of inappropriate empirical therapy, and twofold higher rates of patient death irrespective of underlying illness. 相似文献
992.
993.
Marta Malagn Sara Rami‐Pujol Marta Serrano Mariona Serra‐Pags Joan Amoedo Lia Oliver Anna Bahí Teresa MasdeXaxars Leyanira Torrealba Pau Gilabert Josep Oriol Miquel‐Cusachs Laura García‐Nimo Joan Sal Jordi Guardiola Virginia Piol Joaquin Cubiella Antoni Castells Xavier Aldeguer Jesús Garcia‐Gil 《Alimentary pharmacology & therapeutics》2019,49(11):1410-1420
994.
Lung - Spirometry is required to accurately diagnose chronic obstructive pulmonary disease (COPD). Following an acute exacerbation, it is recommended that spirometry be performed after a delay of... 相似文献
995.
996.
Tove Wästerlid Sara Harrysson Therese M.-L. Andersson Sara Ekberg Gunilla Enblad Per-Ola Andersson Mats Jerkeman Sandra Eloranta Karin E. Smedby 《American journal of hematology》2020,95(7):740-748
Patients with diffuse large B-cell lymphoma (DLBCL) who fail to complete planned treatment with R-CHOP due to toxicity are sparsely described. We investigated the extent of failure to complete treatment (six cycles or more, or three cycles + RT for patients with stage I disease) with R-CHOP for reasons unrelated to non-response, the determinants of such failure and the outcome among these patients. Three thousand one hundred and forty nine adult DLBCL patients who started primary treatment with R-CHOP were identified through the Swedish lymphoma register 2007-2014. Of these, 147 (5%) stopped prematurely after 1-3 cycles of R-CHOP for reasons unrelated to non-response, 168 (5%) after 4-5 cycles and 2639 patients (84%) completed planned treatment. Additionally, 195 (6%) patients did not complete treatment due to non-response or death before treatment end. In a multivariable logistic regression model, age > 75 years, poor performance status, extranodal disease and Charlson Comorbidity Index ≥1 were significantly associated with failure to complete planned R-CHOP treatment for other reasons than non-response. Non-completion of treatment strongly correlated with survival. Five-year overall survival for patients who received 1-3 cycles was 26% (95% CI: 19%-33%), 49% (95% CI: 41%-57%) for 4-5 cycles and 76% (74%-77%) for patients who completed treatment. Failure to complete planned R-CHOP treatment is an important clinical issue associated with inferior survival. Old age and poor performance status most strongly predict such failure. These results indicate a need for improved treatment tailoring for patients with certain baseline demographics to improve tolerability and chance for treatment completion. 相似文献
997.
Maro Ohanian Hagop M. Kantarjian Mahran Shoukier Sara Dellasala Arine Musaelyan Graciela M. Nogueras Gonzalez Elias Jabbour Lynne Abruzzo Srdan Verstovsek Gautam Borthakur Farhad Ravandi Guillermo Garcia-Manero Gevorg Tamamyan Richard Champlin Sherry Pierce Alessandra Ferrajoli Tapan Kadia Jorge E. Cortes 《American journal of hematology》2020,95(10):1127-1134
We aimed to describe the impact of time to response on the outcomes of 75 patients with accelerated-phase chronic myeloid leukemia (CML-AP) at diagnosis. Patients had at least 1 feature of AP: blasts ≥15% (n = 2), basophils ≥20% (n = 19), platelets <100 × 109/L (n = 7), cytogenetic clonal evolution (n = 34), or more than one factor (n = 13). Thirty-three patients received imatinib; 42 received a second-generation tyrosine kinase inhibitor (2GTKI) (19 dasatinib and 23 nilotinib). We used chi-square and Kaplan-Meier analyses to determine the impact of various degrees of molecular and cytogenetic response at early time points (3 and 6 months) on rates of overall cytogenetic and molecular response, overall survival (OS), event-free survival (EFS), transformation-free survival (TFS), and failure-free survival (FFS). After a median follow-up of 96 months (range: 18-224 months), the overall rate of complete cytogenetic response was 79%, of major molecular response, 71%, and of molecular reponse (MR)4.5, 59%. Patients who achieved a major cytogenetic response (MCyR) (n = 49) at 3 months had significantly better 3-year OS (94% vs 75%; P = .002), TFS (98% vs 73%; P < .001), EFS (93% vs 42%; P < .001), and FFS (83% vs 25%; P < .001) rates than patients who did not have MCyR at 3 months. Most (67%) who eventually achieved sustained MR4.5 had achieved MCyR at 3 months. In de novo CML-AP, early response at 3 and 6 months is a strong determinant of long-term outcome. 相似文献
998.
Kaveh Sara Hosseinifard Hossein Ghadimi Nashmil Vojdanian Mahdi Aryankhesal Aidin 《Clinical rheumatology》2020,39(11):3261-3276
Clinical Rheumatology - Osteoporosis is a chronic skeletal disease with an increasing prevalence. Romosozumab, as a monoclonal anti-sclerostin antibody with a dual function, has been produced. In... 相似文献
999.
1000.
Sara Imboden Amal al-Fana Annette Kuhn Michael D. Mueller 《International journal of surgery case reports》2014,5(10):706-709