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https://www.readbyqxmd.com/read/28220735/sustained-reduction-in-antibiotic-consumption-in-a-south-african-public-sector-hospital-four-year-outcomes-from-the-groote-schuur-hospital-antibiotic-stewardship-program
#1
T H Boyles, V Naicker, N Rawoot, P J Raubenheimer, B Eick, M Mendelson
BACKGROUND: Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. OBJECTIVE: To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). METHODS: A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219610/bictegravir-versus-dolutegravir-each-with-emtricitabine-and-tenofovir-alafenamide-for-initial-treatment-of-hiv-1-infection-a-randomised-double-blind-phase-2-trial
#2
Paul E Sax, Edwin DeJesus, Gordon Crofoot, Douglas Ward, Paul Benson, Robin Dretler, Anthony Mills, Cynthia Brinson, Julie Peloquin, Xuelian Wei, Kirsten White, Andrew Cheng, Hal Martin, Erin Quirk
BACKGROUND: All recent treatment guidelines recommend integrase strand transfer inhibitors (INSTIs) as components of initial HIV therapy. Bictegravir, a novel, once-daily, unboosted INSTI, showed potent activity in a 10 day monotherapy study and has a high in-vitro resistance barrier. On the basis of these results, we did a phase 2 trial comparing bictegravir with dolutegravir. METHODS: In this randomised, double-blind, phase 2 trial, we recruited previously untreated adults (aged ≥18 years) with HIV-1 infections from 22 outpatient centres in the USA...
February 14, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#3
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28215889/effects-of-a-combination-butaphosphan-and-cyanocobalamin-product-and-insulin-on-ketosis-resolution-and-milk-production
#4
J L Gordon, T F Duffield, T H Herdt, D F Kelton, L Neuder, S J LeBlanc
The objective of this study was to determine the effects of butaphosphan-cyanocobalamin (B+C), glargine insulin, and propylene glycol on resolution of ketosis and average daily milk yield after treatment. Cows from 16 herds in Ontario, Canada, and 1 herd in Michigan were tested at weekly intervals between 3 and 16 DIM. Ketosis was defined as blood β-hydroxybutyrate (BHB) ≥1.2 mmol/L. All ketotic cows were given a baseline treatment of 3 d of 300 g of propylene glycol orally. Animals were then randomly assigned to treatment with 3 doses of either 25 mL of B+C or 25 mL of saline placebo and 1 dose of either 2 mL (200 IU) of glargine insulin or 2 mL of saline placebo in a 2 × 2 factorial arrangement...
February 16, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28214292/prescription-profile-of-pyridostigmine-use-in-a-population-of-patients-with-myasthenia-gravis
#5
Jorge Enrique Machado-Alba, Luis Felipe Calvo-Torres, Andrés Gaviria-Mendoza, César Augusto Mejía-Vélez
INTRODUCTION: We determined the pyridostigmine prescription pattern in a population of patients with myasthenia gravis. METHODS: A descriptive cross-sectional study was done using a prescription database of 3.5 million individuals from which patients diagnosed with myasthenia gravis (MG) and for whom pyridostigmine was prescribed. RESULTS: A total of 306 outpatients with MG were found, and 258 were receiving pyridostigmine, mean age, 53.0±18...
February 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28202260/allopurinol-benzbromarone-and-risk-of-coronary-heart-disease-in-gout-patients-a-population-based-study
#6
Hsiu-Chen Lin, Masao Daimon, Ching-Hung Wang, Yi Ho, Yow-Shieng Uang, Shuo-Ju Chiang, Li-Hsuan Wang
BACKGROUND: The effect of gout on the risk of developing coronary artery disease (CAD) is uncertain. Some studies have found that gout is a risk factor for acute myocardial infarction. This study examined the changes in risk of CAD in gout patients taking allopurinol and/or benzbromarone, and analyzed the dose-response relationship of both drugs with CAD incidence. METHODS: The medical records of one million subjects from 2000 to 2011 were provided by the Taiwan National Health Insurance Research Database...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28202227/phase-i-trial-of-radiation-therapy-and-sorafenib-in-unresectable-liver-metastases
#7
Rebecca B Goody, Anthony M Brade, Lisa Wang, Tim Craig, James Brierley, Robert Dinniwell, Rebecca K S Wong, Charles Cho, John Kim, Zahra Kassam, Jolie Ringash, Jennifer J Knox, Laura A Dawson
BACKGROUND AND PURPOSE: To determine maximum tolerated dose (MTD) and toxicities of sorafenib combined with stereotactic radiotherapy (SBRT) or whole liver radiotherapy (WLRT) in patients with liver metastases. MATERIAL AND METHODS: Eligible patients had unresectable liver metastases. Sorafenib dose was escalated in 2 strata: I - SBRT: effective liver volume irradiated (Veff)<80% (30-60Gy in 6 fractions); II - WLRT: Veff>80% (21.6Gy in 6 fractions). Four weeks of sorafenib, with radiotherapy during weeks 2-3, was delivered at 3 escalating dose levels (200-400mg twice daily)...
February 12, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28199356/risk-of-dementia-from-proton-pump-inhibitor-use-in-asian-population-a-nationwide-cohort-study-in-taiwan
#8
Shu-Yu Tai, Chen-Yu Chien, Deng-Chyang Wu, Kun-Der Lin, Bo-Lin Ho, Yu-Han Chang, Yang-Pei Chang
INTRODUCTION: Concerns have been raised regarding the potential association between proton pump inhibitor (PPI) use and dementia. OBJECTIVE: This study aimed to examine this association in an Asian population. METHODS: Patients initiating PPI therapy between January 1, 2000 and December 31, 2003 without a prior history of dementia were identified from Taiwan's National Health Insurance Research Database. The outcome of interest was all-cause dementia...
2017: PloS One
https://www.readbyqxmd.com/read/28197654/temozolomide-during-radiotherapy-of-glioblastoma-multiforme-daily-administration-improves-survival
#9
Silke Birgit Nachbichler, Gabi Schupp, Hendrik Ballhausen, Maximilian Niyazi, Claus Belka
BACKGROUND: Temozolomide-(TMZ)-based chemoradiotherapy defines the current gold standard for the treatment of newly diagnosed glioblastoma. Data regarding the influence of TMZ dose density during chemoradiotherapy are currently not available. We retrospectively compared outcomes in patients receiving no TMZ, TMZ during radiotherapy on radiotherapy days only, and TMZ constantly 7 days a week. PATIENTS AND METHODS: From 2002-2012, a total of 432 patients with newly diagnosed glioblastoma received radiotherapy in our department: 118 patients had radiotherapy alone, 210 had chemoradiotherapy with TMZ (75 mg/m(2)) daily (7/7), and 104 with TMZ only on radiotherapy days (5/7)...
February 14, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28194663/cilostazol-use-is-associated-with-reduced-risk-of-dementia-a-nationwide-cohort-study
#10
Shu-Yu Tai, Chen-Yu Chien, Yu-Han Chang, Yuan-Han Yang
Whether antiplatelet agents have a preventive effect on cognitive function remains unknown. We examined the potential association between the use of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, and the risk of dementia in an Asian population. Patients initiating cilostazol therapy between 1 January 2004 and 31 December 2009 without a prior history of dementia were identified from Taiwan's National Health Insurance database. Participants were stratified by age, sex, comorbidities, and comedication...
February 13, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28194539/phase-i-trial-of-mek-1-2-inhibitor-pimasertib-combined-with-mtor-inhibitor-temsirolimus-in-patients-with-advanced-solid-tumors
#11
Monica Mita, Siqing Fu, Sarina Anne Piha-Paul, Filip Janku, Alain Mita, Ronald Natale, Wei Guo, Charles Zhao, Razelle Kurzrock, Aung Naing
Background Dual inhibition of activated MAPK and mTOR signaling pathways may enhance the antitumor efficacy of the MEK 1/2 inhibitor pimasertib and the mTOR inhibitor temsirolimus given in combination. Methods In this phase I study, patients with refractory advanced solid tumors (NCT01378377) received once-weekly temsirolimus plus once-daily oral pimasertib in 21-day cycles in a modified 3 + 3 dose-escalation design. The maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of pimasertib in combination with temsirolimus, safety and pharmacokinetics (PK) were investigated...
February 13, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28183563/effect-of-basal-insulin-dosage-on-blood-glucose-concentration-in-ambulatory-surgery-patients-with-type-2-diabetes
#12
Linda J Demma, Karen T Carlson, Elizabeth W Duggan, John Gordon Morrow, Guillermo Umpierrez
STUDY OBJECTIVE: Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. DESIGN: Observational study. SETTING: Pre- and postoperative holding areas. PATIENTS: One hundred fifty patients with type 2 diabetes using a once daily, evening insulin glargine regimen undergoing ambulatory surgery were included...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181192/single-pill-combination-of-perindopril-indapamide-amlodipine-in-patients-with-uncontrolled-hypertension-a-randomized-controlled-trial
#13
Sergey V Nedogoda, Vesna J Stojanov
INTRODUCTION: Patients with hypertension often require a combination of three antihypertensive agents to achieve blood pressure control, but very few single-pill triple combinations are available. The aim of this study was to determine whether a single-pill triple combination of perindopril, indapamide, and amlodipine was as effective as a dual-pill combination of perindopril/indapamide plus separate amlodipine at reducing blood pressure in patients with uncontrolled, essential hypertension...
February 8, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28179450/prevalence-incidence-and-associated-co-morbidities-of-treated-hypothyroidism-an-update-from-a-european-population
#14
Carlo B Giorda, Paolo Carnà, Francesco Romeo, Giuseppe Costa, Barbara Tartaglino, Roberto Gnavi
OBJECTIVE: Estimates of the prevalence of hypothyroidism in unselected populations date from the late 1990s. We present an update on the prevalence and incidence of overt hypothyroidism in Piedmont, northwest Italy, and examine the association between hypothyroidism and multiple chronic comorbidities. DESIGN AND METHODS: Data were obtained from drug prescription and hospital discharge databases. Individuals who had received at least two levothyroxine prescriptions in 2012 were defined as having hypothyroidism; those who had undergone thyroidectomy or I131 irradiation in the previous 5 years were defined as having iatrogenic hypothyroidism; and those who had either obtained exemption from treatment co-payment or had been discharged from hospital with a chronic comorbidity (diabetes, connective tissue diseases) were identified as having one of these conditions...
February 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28165318/an-evaluation-approach-for-the-performance-of-dosing-regimens-in-attention-deficit-hyperactivity-disorder-treatment
#15
Guillaume Bonnefois, Philippe Robaey, Olivier Barrière, Jun Li, Fahima Nekka
OBJECTIVE: Stimulant medications, with methylphenidate as the main agent, are the most prescribed for the treatment of attention-deficit/hyperactivity disorder. Nevertheless, real challenges still remain for clinicians concerned with adaptation of the therapeutic regimens, in terms of doses and timing, to children's daily activities. The aim of this study was to optimize short-acting methylphenidate regimens according to specific children's needs by evaluating the performance of a particular regimen through a web-based application...
February 6, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28161921/prevalence-of-steroid-induced-cataract-and-glaucoma-in-chronic-obstructive-pulmonary-disease-patients-attending-a-tertiary-care-center-in-india
#16
Tirupati Nath, Subham Sinha Roy, Himanshu Kumar, Rachit Agrawal, Santosh Kumar, S K Satsangi
PURPOSE: Exposure to corticosteroids is known to be associated with an increased risk of cataract and glaucoma. This study was undertaken to determine the prevalence of steroid-induced cataract and glaucoma in patients with chronic obstructive pulmonary disease (COPD) and to assess a dose-response relationship between them. DESIGN: This was a prospective observational study. METHODS: We identified all COPD patients aged 50 years or older, with minimum steroid exposure of 4 months and on inhaled corticosteroids from March 2014 to March 2015...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28160872/selective-serotonin-reuptake-inhibitors-and-poststroke-epilepsy-a-population-based-nationwide-study
#17
Chien-Chen Chou, Der-Jen Yen, Yung-Yang Lin, Yu-Chiao Wang, Cheng-Li Lin, Chia-Hung Kao
OBJECTIVE: To investigate the effects of selective serotonin reuptake inhibitors (SSRIs) on poststroke epilepsy in a population-based nationwide study. PATIENTS AND METHODS: The SSRI group included patients who received a stroke diagnosis from January 1, 2000, through December 31, 2009, and were prescribed SSRIs after stroke. The non-SSRI group enrolled patients with stroke who were not prescribed SSRIs from the Taiwan National Health Insurance Research Database and used propensity score matching based on the index year, duration time, sex, age, type of stroke, and duration of hospitalization...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28158982/study-protocol-thyroid-hormone-replacement-for-untreated-older-adults-with-subclinical-hypothyroidism-a-randomised-placebo-controlled-trial-trust
#18
David J Stott, Jacobijn Gussekloo, Patricia M Kearney, Nicolas Rodondi, Rudi G J Westendorp, Simon Mooijaart, Sharon Kean, Terence J Quinn, Naveed Sattar, Kirsty Hendry, Robert Du Puy, Wendy P J Den Elzen, Rosalinde K E Poortvliet, Jan W A Smit, J Wouter Jukema, Olaf M Dekkers, Manuel Blum, Tinh-Hai Collet, Vera McCarthy, Caroline Hurley, Stephen Byrne, John Browne, Torquil Watt, Douglas Bauer, Ian Ford
BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. METHODS: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4...
February 3, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28139511/evaluation-of-outpatient-antibiotic-use-in-beijing-general-hospitals-in-2015
#19
Chuan Yang, Wen-Qiang Cai, Zi-Jun Zhou
BACKGROUND: Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015. METHODS: We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28131322/safety-tolerability-and-sensorimotor-effects-of-extended-release-dalfampridine-in-adults-with-cerebral-palsy-a-pilot-study
#20
Francois Bethoux, Ali Fatemi, Eileen Fowler, Christina Marciniak, Angeli Mayadev, Joel Waksman, Kathleen Zackowski, Gustavo Suarez, Andrew R Blight, Adrian L Rabinowicz, Enrique Carrazana
PURPOSE: The goal of this study was to evaluate the safety and tolerability of dalfampridine extended release (D-ER) in a pilot study of adults with cerebral palsy (CP) and limited ambulatory ability, and to explore drug effects on sensorimotor function. METHODS: An initial double-blind, single-dose crossover study was performed in 11 individuals randomized 1:1 to receive D-ER (10 mg) or placebo, followed by a 2-day washout period and the opposite treatment, with evaluation for safety and tolerability...
January 25, 2017: Clinical Therapeutics
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