31 results

Differences between medical and surgical teams on antibiotic use

Decision making in antibiotic use is conditioned by cultural and social determinants. A paper evaluated acute medical and acute surgical teams at a London teaching hospital using ethnographic techniques (i.e., a qualitative study approach). The conclusions of the study were that in surgery, the antibiotic treatment is perceived as nonsurgical intervention and delegated to junior team members, because senior surgeons are notably absent from wards – they prefer to be in the operating room. This fact leads to defensive antibiotic […]

Use of Ribaxamase (SYN-004), a beta lactamase, to prevent Clostridium difficile infection in Beta lactam treated patients: a double blind phase randomized placebo controlled trial

Beta lactam antibiotics are considered risk factors for clostridioides difficile infection. These antibiotics are excreted by the bile in the gut and maintain antibiotic levels at this site. Ceftriaxone is highly excreted by the biliary tree. This excretion can continues up to 48 hours after discontinuation of intravenous ceftriaxone and may lead to concentrations as high as 1 mg/ml in the intestinal fluid. Ribaxamase degrades beta lactams and could help preventing C diff infection. This was a study including 433 […]

The rise of documentation and the destruction of modern Medicine

Doctor-patient relationship has been a central concept in Medicine since Hippocrates, if not before that time. Investing time into this relationship ensures trust and communication during a patient’s most vulnerable moments. The widespread use of the electronic health record has changed the doctor-patient relationship, i.e., instead of person to person communication, now, mostly, is doctor to electronic health record communication. A recent study in the United States found that physicians spent 24% of their time talking with patients and 44% […]

Pembrolizumab treatment for progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy is an opportunistic brain infection caused by the JC virus, a virus commonly present in kidneys. Immunosuppressed patients with low T cell counts or function are the victims of this viral infection that is usually fatal unless the immune function is restored. Programmed cell death protein 1 found on the surface of T cells suppresses T cells function. The blockage of this protein leads to an increased immune functioning. This report included 8 patients with progressive multifocal […]

Recent research suggests that amyloid-beta proteins associated with Alzheimer disease can be transmitted via medical and surgical procedures person-to-person

This evidence presents the initial studies on Creutzfeldt-Jakob disease as a consequence of treatment with cadaver-derived human growth factor hormone.  Post-mortem brain tissue revealed that patients had developed cerebral amyloid deposition in addition to the lesions due to mad cow disease. Clearly, those individuals will never developed Alzheimer because of absence of lifetime to do so. A study of material used for hormone growth extracted from human brain tissue and conserved for more than 30 years, showed in some batches substantial […]

Antibiotic management of urinary tract infections in elderly patients ( 65 years and more) in primary care and its association with bloodstream infections and all cause mortaliy: population based cohort study

This is a big data study including 157,264 patients with 312,896 urinary tract infections episodes. Of these patients, 7.2 % did not have antibiotics being prescribed and 6.2 % a delay in antibiotic prescribing. 1,539 bloodstream infections deriving from UTI were registered (0.5 %) within 60 days after urinary track infection diagnosis. The rate of bloodstream infections were more common among patients who did not have prescription of antibiotics (2.9 %, 647) and patients with delayed prescription (2.2 %). Hospital […]

A therapeutic strategy for all pneumonia patients: a 3-year prospective multicenter cohort study using risk factors for multiresistant pathogens to select initial empiric therapy

Pneumonia empiric therapy is currently based on the site of acquisition (community or hospital), but could be chosen, based on risk factors for multiresistant (MDR) pathogens. The authors applied an algorithm to 1,089 patients using MDR risks (antibiotic use on the last 180 days before pneumonia diagnosis, poor functional state, hospitalized patient for more than 2 days within the last 90 days before pneumonia diagnosis, pneumonia occurring for 5 or more days after admission to acute care hospital, hemodialysis and […]

Inhaled liposomal ciprofloxacin in patients with noncystic fibrosis bronchiectasis and chronic lung infection with Pseudomonas aeruginosa ( orbit-3 e orbit-4): tow phase 3, randomized controlled trials

Patients with non-cystic fibrosis bronchiectasis and lung infection due to Pseudomonas aeruginosa experience frequent infection exacerbations, decreased in quality of life, and increased in mortality. Orbit-3 and ORBIT-4 were randomized double blind, placebo controlled trials that applied liposomal ciprofloxacin or placebo inhalation to their study population. Results were not remarkable, however, patients treated with inhaled ciprofloxacin had less frequent pulmonary exacerbations than those treated with placebo. Hawoth CS, Bilton D, Chalmers JD, Davis AM, Forehlich J, Gonda I, et al. […]

Strain-specific antibody therapy prevents cytomegalovirus reactivation after transplantation

Cytomegalovirus infection and its reactivation is frequent after solid organs and hematopoietic stem cell transplantation, and this infection can cause significant impact on transplantation outcomes. In mouse experimental models and in hematopoietic stem cells, an infusion in the presence of strain-specific anti-cytomegolovirus, was protective. There is the need for antibodies specific for the strain that was presented. Commercial immunoglobulin infusions were tried in bone marrow transplantation and solid organ transplantation as prophylactic or therapeutic measures against cytomegalovirus, but trials did […]

We need to develop new antibiotics

Progressing of antibiotic resistance in bacteria erodes our therapeutic resources. Some infections are caused by bacteria that have only one or no therapeutic options. New antibacterial agents should be developed, but economic considerations conspire against investing in this market. Antibiotics are used, at most, two weeks for serious infections, and there is a tendency of lesser time use. Infection control wants exactly that: to control new antibiotic use to delay resistance, so the market for those new drugs is restricted. […]

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