Background: Current guidelines recommend bridging anticoagulation in patients undergoing cardiac rhythm device surgery with a "moderate to high risk" of thromboembolism. Patients at "low risk" are advised to stop oral anticoagulation without bridging to the procedure. This study examines real world adherence to accepted guidelines and the clinical sequelae of ...

Intraoperative hyperglycemia has been observed to be associated with increased morbidity and mortality after cardiac surgery. Dextrose cardioplegia is used for its cardioprotective effects but may lead to intraoperative hyperglycemia and more postoperative complications. This was a retrospective observational study. Patient records (n = 2301) were accessed from a large ...

PURPOSE: Catheter-associated bacteriuria (CAB) with transurethral catheters is almost inevitable. Suprapubic catheters (SPCs) are widely considered to decrease the risk of CAB. However, SPCs are implants similarly prone to microbial biofilm formation. The spectrum of colonising pathogens has not been investigated. The aim of this prospective study was: (1) to ...

We hypothesized that human atrial fibrillation (AF) may be sustained by localized sources (electrical rotors and focal impulses), whose elimination (focal impulse and rotor modulation [FIRM]) may improve outcome from AF ablation. Catheter ablation for AF is a promising therapy, whose success is limited in part by uncertainty in the ...

Selective patellar resurfacing continues in total knee arthroplasty (TKA). We define the demographics of patients selected for this procedure and report their short-term, aseptic revision rate. A community-based Total Joint Replacement Registry (TJRR) comprising 39,000 TKAs with median follow-up of 24.5 months was evaluated. Patients who underwent bicompartmental TKA were ...

Background: Ablation in the noncoronary aortic cusp (NCC) potentially has a role in the treatment of perinodal atrial tachycardias (ATs). The objective of the study was to characterize clinical and electrophysiological properties of perinodal ATs between two groups of requiring and not requiring NCC ablation. Methods: A total of 113 ...

OPINION STATEMENT: Dystonia is characterized by repetitive twisting movements or abnormal postures due to involuntary muscle activity. When limited to a single body region it is called focal dystonia. Examples of focal dystonia include cervical dystonia (neck), blepharospasm (eyes), oromandibular dystonia, focal limb dystonia, and spasmodic dysphonia, which are discussed ...

Background: Individuals with proximal femoral focal deficiency (PFFD) present with a shortened femur. This report highlights the process used to determine prosthetic candidacy, a novel use of the International Committee of the Red Cross (ICRC) prosthetic materials, and subsequent rehabilitation when treating in rural Haiti.Case Description and Methods: An eight-year-old ...

Purpose: To evaluate the therapeutic effect and safety of intravitreal ranibizumab (RBZ) or RBZ combined with focal/grid laser in diabetic macular edema (DME). Design: Systematic review of randomized clinical control trials (RCCTs) comparing RBZ or RBZ combined with focal/grid laser to non-drug control or focal/grid laser in DME was performed. ...

Approximately 775,000 hip and knee arthroplasties are performed yearly in the United States, with a dramatic increase expected. Patients having hip and knee arthroplasties are at high risk of developing a venous thromboembolism. The American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS) have updated ...

There are very limited data on the impact of ART initiation on inflammatory and coagulation biomarkers compared to patients who remain ART naïve [1]. We designed a prospective comparative study to evaluate these changes. Prospective observational cohort study of HIV-infected patients who start ART and a group of age-matched controls ...

Deep brain stimulation (DBS) is an established and accepted treatment modality of generalized dystonia. The stereotactic target to be approached with DBS leads is the internal segment of the globus pallidus (GPi). Bilateral GPi stimulation in patients suffering from primary generalized dystonia reduced dystonic movement not only in the trunk ...

Purpose of the study: Promising research suggest that maraviroc (MVC) has favourable clinical outcome in HIV-infected patients (pts). Aim of the study is to assess: durability, safety profile and immunovirological recovery in a large MVC-based cohort. Methods: All HIV pts treated with antiretroviral therapy (ART) containing MVC for at least ...

IntRODUCTION: To evaluate the effect of American Society of Anesthesiology (ASA) scores on percutaneous nephrolithotomy (PNL) outcomes. The records of 186 consecutive patients undergoing PNL procedures from 2006 to 2011 at a single institution were evaluated. Patients were divided into a low-risk group with a preoperative ASA of I or ...

Dysentery is one of the children's common disease for which various infectious and non-infectious reasons have been explained for it. Since determination of the cause especially with age segregation helps the experimental treatment, this study has been executed to establish relative Of frequency of dysentery causes and its comparison below ...

The standard treatment of brucellar spondylitis with a combination of two antibiotics for 6-12 weeks is associated with high rates of treatment failure and relapse. The present study aimed to assess the safety and efficacy of a treatment strategy based on the prolonged administration of a triple combination of suitable antibiotics. ...

OBJECTIVE: To examine patterns of pharmacotherapy and healthcare utilization and cost prior to total hip replacement (THR) or total knee replacement (TKR) in patients with osteoarthritis (OA). METHODS: Using a large US health insurance claims database, we identified all patients with OA, aged ≥40 years, who underwent TKR or THR ...

Aim  About 5% of restorative proctocolectomy (RPC) patients develop chronic antibiotic-dependent pouchitis. These require antibiotic maintenance therapy. We report our experience in managing this patient group. Method  Patients with RPC that was treated with antibiotic maintenance therapy were identified from the hospital pouch database. Data including faecal antibiotic sensitivity, functional ...

BACKGROUND: External chest compressions (ECC) are essential components of resuscitation and are usually performed without any adjuncts in professional healthcare. Even for healthcare professionals during in-hospital and out-of-hospital resuscitation poor performance in ECC has been reported in recent years. Although several stand-alone devices have been developed none has been implemented ...

To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. We conducted a 6-month randomized, controlled clinical trial involving ...

Several studies have reviewed the management of ankylosis of the temporomandibular joint (TMJ), but only a few focused on the aetiology and clinical features. We retrospectively studied the aetiology and clinical features of patients with ankylosis of the TMJ who presented to the Maxillofacial Unit, National Hospital, Abuja, Nigeria, between ...

Background: Evidence is currently equivocal on the added benefits of dual blockade of the renin-angiotensin-aldosterone system with the combination of either an ACE inhibitor (ACEI) plus an angiotensin II type 1 receptor antagonist (angiotensin receptor blocker [ARB]) or aliskiren, the first-in-class direct renin inhibitor, plus an ARB. Objective: To compare ...

SUMMARY AT A GLANCE: This study assessed the effect of early rehabilitation programme following acute exacerbation of COPD over a period of 1 year. We found that an 8-week programme resulted in better health status of the subjects at 6 months but without reduction in healthcare utilization at 1 year. ...

The goal of this study was to assess whether patients receive their antibiotic prophylaxis as prescribed. We also investigated what doses and durations of antibiotics are typically ordered, which patients actually receive antibiotics and factors causing the ordered antibiotic regimen to be altered. We performed a retrospective review of 205 ...

Objectives: To determine the elution properties of meropenem and to compare the elutions of meropenem-impregnated polymethylmethacrylate (PMMA) beads without sterilization (P-M-C) to those sterilized with steam (P-M-A) and ethylene oxide gas (P-M-EO). Methods: A commercial bead mould was used to produce four groups of beads: one group without antibiotic (negative ...

Objectives To determine whether the introduction of a community-acquired pneumonia (CAP) severity assessment tool to guide antibiotic selection could reduce broad-spectrum antibiotic prescribing without compromising patient safety. Methods A prospective before and after evaluation study. Empirical antibiotic prescribing was studied for 18 months from June 2006 to January 2008 (pre-intervention) ...

To investigate if antibiotics administered within 8 h of endoscopy reduce mortality or increase the incidence of Clostridium difficile infection (CDI). A 2-year retrospective analysis of all patients who presented with first variceal hemorrhage was undertaken. The primary outcome measure was 28-d mortality. Secondary outcome measures were 28-d rebleeding rates ...

The objective of this study was to evaluate the results of drainage and continuous antibiotic irrigation of the medullary canal to mediate hematogenous osteomyelitis of the tibia in children. Data were analyzed from 376 patients (388 tibiae) treated from January 1982 to December 2004. The average age at the time ...

The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. A briefing score (1, never started; 2, started then discontinued; 3, maintained on original targeted cases; 4, expanded to other services; 5, briefing ...

To evaluate whether changing antibiotic prophylaxis from quinolone to penicillin antibiotics has affected infectious complication rates in those men undergoing transrectal ultrasound-guided prostate biopsy (TRUSgpb). This interventional study was designed to determine whether changing antibiotic prophylaxis had any bearing on developing serious infectious complications after taking TRUSgpb. As a secondary ...

One hundred and fifty-seven patients undergoing high-dose chemotherapy (HDT) and autologous stem-cell transplantation (ASCT) for hematopoietic malignancies and solid tumors were randomly assigned to receive (Group A) or not (Group B) prophylaxis with ciprofloxacin, orally, and vancomycin, intravenously. Prophylactic antibiotics were given from day 0 until resolution of neutropenia or ...

To compare the aqueous humour penetration of moxifloxacin 0.5% and gatifloxacin 0.3% eye drops administered in two different dosing regimens during phacoemulsification surgery. This prospective, randomised study included 97 patients. The patients were randomly divided into two treatment groups to receive either moxifloxacin or gatifloxacin. All patients received the topical ...

Many similarities exist between pyogenic flexor tenosynovitis and other closed-space infections such as septic arthritis. Previous studies have demonstrated that corticosteroids in conjunction with antibiotics considerably improve treatment outcomes in patients with septic arthritis. Using a chicken model, we investigated whether or not corticosteroids in combination with antibiotics and/or surgical ...

To investigate the clinical significance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. The endpoints of antibiotic treatment in 46 patients with pyogenic liver abscess after complete percutaneous drainage were assessed by performing a retrospective study. After complete percutaneous drainage, normal ...

Recent medical literature suggests that use of fluoroquinolones (FQs) might be associated with the delayed diagnosis of pulmonary tuberculosis (TB). The purpose of this study was to assess the impact of radiographic evidence of prior pulmonary TB infection on empiric antibiotic choice in cases of community-acquired pneumonia (CAP), as well ...

BACKGROUND: Limited data exist on optimal empiric oral antibiotic treatment for outpatients with cellulitis in areas with a high prevalence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) infections. METHODS: We conducted a 3-year retrospective cohort study of outpatients with cellulitis empirically treated at a teaching clinic of a tertiary-care medical center ...

To determine whether postdating delayed antibiotic prescriptions results in a further decrease (over usual delayed prescriptions) in antibiotic use. Randomized controlled trial. A small rural town in Newfoundland and Labrador. A total of 149 consecutive adult primary care patients who presented with acute upper respiratory tract infections. Delayed prescriptions for ...

There is a growing interest in methane and its association with constipation in functional bowel disease. Neomycin-based treatment of methane-positive subjects has resulted in improvement of constipation. Rifaximin, although superior for the treatment of irritable bowel syndrome compared with other antibiotics, seems less effective in methane-positive subjects. In this study, ...

Septic shock represents the major cause of infection-associated mortality in the intensive care unit. The possibility that combination antibiotic therapy of bacterial septic shock improves outcome is controversial. Current guidelines do not recommend combination therapy except for the express purpose of broadening coverage when resistant pathogens are a concern. To ...

In the majority of surgical departments in Denmark, the postoperative treatment for acute perforated appendicitis comprises three days of intravenous antibiotics. Recently, it has been proposed that such antibiotic regimen should be replaced by orally administered antibiotics. The aim of this paper was to give an overview of studies on ...

Recurrent Clostridium difficile infection (RCDI) is an increasingly common clinical problem without ideal treatment options. Our aim was to evaluate our results using Fecal Flora Reconstitution (FFR), and promulgate our methodology to the GI community to foster its more widespread use in appropriate candidates. FFR, sometimes termed "fecal transplantion" has ...

To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were ...

To assess the impact of medication frequency illustrations in patient education for use in the developing world. This was a randomized controlled trial of a study population of patients undergoing cataract surgery in St/Louis du Nord, Haiti. Patients and accompanying family members were randomized prior to surgery to receive either ...

To determine the utility of adding oral nonabsorbable antibiotics to the bowel prep prior to elective colon surgery. Bowel preparation prior to colectomy remains controversial. We hypothesized that mechanical bowel preparation with oral antibiotics (compared with without) was associated with lower rates of surgical site infection (SSI). Twenty-four Michigan hospitals ...

Determining bacterial aetiology of acute sinusitis is difficult without employing invasive procedures. Most episodes of acute sinusitis resolve spontaneously. Antibiotics have demonstrated efficacy for the treatment of acute bacterial sinusitis in clinical trials yet little is known of their effectiveness in real-life treatment settings. Most cases of untreated acute sinusitis ...

PURPOSE: Treatment for vesicoureteral reflux remains controversial. Lacking an evidence-based treatment protocol, we offered the option of terminating prophylactic antibiotics in otherwise healthy patients with persistent vesicoureteral reflux at age 5 years or greater. We report outcomes with respect to the urinary tract infection incidence and to whether surgical intervention ...

The authors sought to determine the prevalence, risk factors, and clinical impact of complications associated with outpatient parenteral antimicrobial therapy (OPAT) in children. A cohort of patients ≤18 years old with infections, who received OPAT were evaluated retrospectively. Antibiotic-associated complications (AACs), catheter-associated complications (CACs), and unplanned medical care visits were ...

Early diagnosis of acute appendicitis, known as the most frequent cause of acute surgical abdominal pathologies, dramatically decreases the related complications. D-lactate, produced by intestinal bacteria as a fermentation product, may be useful in diagnosing acute abdominal pathologies. The aim of this study was to investigate whether the presence of ...

A randomized controlled trial was conducted to clarify whether continuous regional arterial infusion (CRAI) of protease inhibitor and antibiotic could reduce mortality rate of severe acute pancreatitis (SAP). Seventy-eight patients with SAP were included in the study. Thirty-nine patients were treated with CRAI, 31 patients completed the study; and another ...

Very recently it has been shown that hyperbilirubinemia is a specific predictor of perforation in acute appendicitis. We compared the diagnostic importance of bilirubin, C-reactive protein (CRP), leukocyte count and age as markers of perforation in acute appendicitis. A two-center retrospective cohort study was completed. Patients with acute appendicitis (n ...