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https://www.readbyqxmd.com/read/29791985/-management-of-acute-cholecystitis
#1
REVIEW
Seung Ok Lee, Sung Kyun Yim
Acute cholecystitis is a common serious complication of gallstones. The reported mortality of acute cholecystitis is approximately 3%, but the rate increases with age or comorbidity of the patient. If appropriate treatment is delayed, complications can develop as a consequence with a grave prognosis. The current standard of care in acute cholecystitis is an early laparoscopic cholecystectomy with the appropriate administration of fluid, electrolyte, and antibiotics. On the other hand, the severity of the disease and patient's operational risk must be considered...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29781594/-monoclonal-spread-of-multi-drug-resistant-ctx-m-15-producing-klebsiella-pneumoniae-impact-of-measures-to-control-the-outbreak
#2
M A Asencio Egea, M Huertas Vaquero, C Muñoz-Cuevas, J Gaitán Pitera, O Herráez Carrera, P Alcázar Carmona, H D Patiño Ortega, M Franco Huerta, C Román Ortiz, M C Conde García, R Carranza González, J R Barberá, V Bautista Sánchez
OBJECTIVE: To describe an outbreak of multi-drug resistant extended-spectrum β-lactamases-producing Klebsiella pneumoniae (MDR-ESBL-KPN) and the impact of measures for its control. METHODS: We reviewed the patients´ clinical records with MDR-ESBL-KPN isolation during 2013-2016 with resistance to fluoroquinolones, aminoglycosides, fosfomycin, and nitrofurantoin; susceptible to imipenem, meropenem, colistin, and tigecycline and variable to ertapenem and cotrimoxazole (Vitek-2)...
May 18, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29777488/no-need-for-a-urine-culture-in-elderly-hospitalized-patients-with-a-negative-dipstick-test-result
#3
Zvi Shimoni, Vered Hermush, Joseph Glick, Paul Froom
To determine the clinical utility/disutility of canceling urine cultures in elderly patients with a negative dipstick. The cohort included consecutive patients aged ≥ 65 years hospitalized in internal medicine departments with an admission urinalysis and urine culture (January 1, 2014 to December 31, 2016). We calculated the sensitivity of the dipstick (either a trace leukocyte esterase or a positive nitrite test result) to detect patients with bacteriuria, and the decrease in urine cultures resulting from cancelation in patients with a negative dipstick...
May 18, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29772856/-application-of-broad-easy-immediate-surgery-in-percutaneous-transforaminal-endoscopic-technology-for-lumbar-lateral-recess-stenosis-in-the-elderly
#4
Shi-Min Zhang, Guan-Nan Wu, Jiao Jin, Yu-Zhang Liu, Zuo-Xu Li, Zhao-Jie Zhang, Ming Ma, Tao Chong, Yong-Dong Zhang
OBJECTIVE: To explore the safety and effectiveness of percutaneous transforaminal endoscopic BEIS technology for lumbar lateral recess stenosis in the elderly. METHODS: From February 2014 to May 2016, 21 patients with lumbar lateral recess stenosis in elderly were treated with percutaneous endoscopic BEIS. There were 13 males and 8 females, aged from 70 to 85 years old with an average of 74.3 years. Preoperative, 1 and 12 months postoperative visual analogue scale(VAS) scores and Oswestry Disability Index(ODI) were statistically analyzed...
April 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29769511/an-elderly-lady-with-neurobrucellosis-and-multiple-co-morbid-conditions
#5
M N Islam
Neurobrucellosis is a rare (1.7-7.0% of prevalence) neurological complication of brucellosis which has neither a typical clinical picture nor specific cerebrospinal fluid (CSF) findings and mimics other neurological disorders leading to clinical diagnostic dilemmas. This study describes one elderly patient of neurobrucellosis with fever, irrelevant behavior, sweating, fatigue, drowsiness, neck stiffness inability to speak and reduced activity for about 10 days hailing from Beanibazar, Sylhet, Bangladesh admitted in Mount Adora Hospital, Sylhet, Bangladesh on 16th October 2016...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29760598/predictors-of-chemoradiation-related-febrile-neutropenia-prophylaxis-in-older-adults-experience-from-a-limited-resource-setting
#6
Aparna Gangopadhyay
Aim: To identify risk factors that lower efficacy of antibiotic prophylaxis of febrile neutropenia among older patients on chemoradiation. Background: Audit of institutional data showed that older adults are at higher risk of febrile neutropenia during chemoradiation. In limited resource settings widespread use of Granulocyte-Colony Stimulating Factor (G-CSF) is not economically feasible and antibiotics are used commonly. Despite compliance with antibiotics, prophylaxis is inadequate in many patients owing to patient and tumor related factors...
May 2018: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29752963/ses-proteins-as-possible-targets-for-vaccine-development-against-staphylococcus-epidermidis-infections
#7
Dorien Hofmans, Laleh Khodaparast, Ladan Khodaparast, Els Vanstreels, Mohammad Shahrooei, Johan Van Eldere, Lieve Van Mellaert
OBJECTIVES: The opportunistic pathogen Staphylococcus epidermidis is progressively involved in device-related infections. Since these infections involve biofilm formation, antibiotics are not effective. Conversely, a vaccine can be advantageous to prevent these infections. In view of vaccine development, predicted surface proteins were evaluated on their potential as a vaccine target. METHODS: Immunoglobulins directed against S. epidermidis surface proteins SesB, M, O, Q and R, were used to firstly affirm their surface location...
May 9, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29752197/panophthalmitis-caused-by-streptococcus-dysgalactiae-subsp-equisimilis-a-case-report-and-literature-review
#8
Hideharu Hagiya, Takuya Semba, Takeshi Morimoto, Norihisa Yamamoto, Hisao Yoshida, Kazunori Tomono
Lancefield group G β-hemolytic Streptococcus dysgalactiae subspecies equisimilis (SDSE) has become a leading causative pathogen of invasive streptococcal infection. In this report, we describe a case of disseminated SDSE infection complicated by endogenous endophthalmitis, resulting in panophthalmitis and blindness. A 65-year-old man who underwent mitral valve replacement surgery two months previously was hospitalized due to high fever and right visual loss. A systemic investigation revealed endophthalmitis complicated by mediastinal abscess, prosthetic infective endocarditis, cerebral emboli and hemorrhage, and multiple arthritis...
May 8, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29739393/involvement-in-decisions-about-intravenous-treatment-for-nursing-home-patients-nursing-homes-versus-hospital-wards
#9
Kristin Klomstad, Reidar Pedersen, Reidun Førde, Maria Romøren
BACKGROUND: Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient's best interest, assessment of capacity to consent, and on the patient's own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. METHODS: Using a questionnaire, we studied the decision-making process for 299 nursing home patients who were treated for dehydration using intravenous fluids, or for bacterial infections using intravenous antibiotics...
May 8, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29725956/use-of-prophylactic-saccharomyces-boulardii-to-prevent-clostridium-difficile-infection-in-hospitalized-patients-a-controlled-prospective-intervention-study
#10
Jeppe West Carstensen, Mahtab Chehri, Kristian Schønning, Steen Christian Rasmussen, Jacob Anhøj, Nina Skavlan Godtfredsen, Christian Østergaard Andersen, Andreas Munk Petersen
Clostridium difficile infection (CDI) is a common complication to antibiotic use. Saccharomyces boulardii has shown effect as a prophylactic agent. We aimed to evaluate the efficacy of S. boulardii in preventing CDI in unselected hospitalized patients treated with antibiotics. We conducted a 1 year controlled prospective intervention study aiming to prescribe Sacchaflor (S. boulardii 5 × 109 , Pharmaforce ApS) twice daily to hospitalized patients treated with antibiotics. Comparable departments from three other hospitals in our region were included as controls...
May 3, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29716725/staphylococcus-aureus-colonization-in-an-institutionalized-elderly-population-long-term-care-facilities-in-the-bay-of-cadiz-area-spain-prevalence-and-associated-risk-factors
#11
María Pérez-Eslava, Nuria López-Ruíz, Elvira María Flores-Cebada, Manuel Rodríguez-Iglesias, Fátima Galán-Sánchez
BACKGROUND AND OBJECTIVE: Staphylococcus aureus is a health problem behind a great variety of infections. The objective of the study was to establish the prevalence and risk factors of S. aureus carriers in community nursing homes in Cadiz. PATIENTS AND METHOD: A cross study from September 2016 to May 2017. POPULATION: All residents institutionalized in the largest long-term care facilities centers in Cadiz. The main variable was being a S...
April 28, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29714807/-time-to-limit-the-use-of-antibiotics-in-rosacea
#12
Håkan Mobacken, Mats Berg, Eva Angesjö, Kari Dunér, Margareta Svensson, Ingrid Synnerstad
Rosacea is a chronic inflammatory disease with facial erythema and papulopustules. It is common in middle-aged/elderly persons and often affects self-perception and social well-being. It is generally classified into four subtypes. Improved understanding of pathophysiology has resulted in novel treatment approaches, but routine management in health care usually follows old trails. Most patients are managed in primary care. Greater attention to the reduced skin barrier, avoidance of exacerbating factors, better topicals and encouragement to topical maintenance treatment should reduce the use of oral tetracyclines...
April 24, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29708869/delayed-cholecystectomy-for-acute-cholecystitis-in-elderly-patients-treated-primarily-with-antibiotics-or-percutaneous-drainage-of-the-gallbladder
#13
Gaëtan-Romain Joliat, Grégoire Longchamp, Céline Du Pasquier, Alban Denys, Nicolas Demartines, Emmanuel Melloul
BACKGROUND: In high-risk patients with acute cholecystitis, antibiotics with or without percutaneous drainage of the gallbladder followed by delayed cholecystectomy (DC) can be performed. This study aimed to review our current management of elderly patients with acute cholecystitis treated with DC. METHODS: All consecutive patients older than 70 with acute cholecystitis treated primarily with antibiotics with or without percutaneous drainage followed by DC between 2006 and 2015 were retrospectively reviewed...
April 30, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29703022/adolescent-pr3-anca-positive-hypertrophic-pachymeningitis-a-case-report-and-review-of-the-literature
#14
Kotaro Matsumoto, Mitsuhiro Akiyama, Nobuhiko Kajio, Kotaro Otomo, Kazuko Suzuki, Naoshi Nishina, Kento Kasuya, Naoki Oishi, Kaori Kameyama, Tsutomu Takeuchi
RATIONALE: Hypertrophic pachymeningitis (HP) is an uncommon, life-threatening disease that is seen in elderly patients with antineutrophil cytoplasmic antibody (ANCA) positivity. Proteinase-3 (PR3)-ANCA-positive HP has not been reported in adolescents. Here, we report the first case of adolescent PR3-ANCA-positive HP successfully treated with immunosuppressive therapy. PATIENT CONCERNS: A 14-year-old female presented with fullness and pain in her right ear unresponsive to antibiotics...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701371/surgical-treatment-of-complications-55-years-after-extraperiosteal-lucite-ball-plombage-for-pulmonary-tuberculosis
#15
Telma Calado, Magda Alvoeiro, Daniel Cabral, Mariana Antunes, Francisco Félix
INTRODUCTION: In the 1930-50s, before the introduction of antimicrobial drugs and development of techniques of pulmonary resssection, collapse therapy was the mainstream of treatment for cavitary pulmonary tuberculosis. The methods to achieve the collapse included artificial pneumothorax with air refills, phrenic nerve crush, thoracoplasty and extrapleural plombage. The plombage involves creating a cavity surgically under the ribs in the upper chest wall and filling the space with inert material, such fat, paraffin wax, rubber ballons, oil and methyl-methacrylate (Lucite) balls...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29675786/the-microbiology-of-infected-pancreatic-necrosis-in-the-era-of-minimally-invasive-therapy
#16
Nadav Sahar, Richard A Kozarek, Zaheer S Kanji, Shingo Chihara, S Ian Gan, Shayan Irani, Michael Larsen, Andrew S Ross, Michael Gluck
We aimed to determine the microbiology of infected walled-off pancreatic necrosis (WON) in an era of minimally invasive treatment, since current knowledge is based on surgical specimens performed over two decades ago. We retrospectively analyzed a prospectively maintained database of patients who were treated for symptomatic WON using combined endoscopic and percutaneous drainage between 2008 and 2017. Aspirates from WON at initial treatment were evaluated. One hundred eighty-two patients were included with a mean age of 56 of whom 67% were male...
April 19, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29664994/predictors-of-mortality-with-staphylococcus-aureus-bacteremia-in-elderly-adults
#17
Matteo Bassetti, Elda Righi, Paola Del Giacomo, Assunta Sartor, Filippo Ansaldi, Cecilia Trucchi, Cristiano Alicino, Enrico Maria Trecarichi, Teresa Spanu, Chiara Paganino, Mario Tumbarello, Alessia Carnelutti
OBJECTIVES: To analyze risk factors for early and late mortality in individuals aged 75 and older with Staphylococcus aureus bacteremia (SAB) in Italy. DESIGN: Four-year retrospective observational study (January 2011-December 2014). SETTING: Two tertiary care university hospitals in Italy (Santa Maria Misericordia Hospital in Udine, Policlinico Universitario Agostino Gemelli in Rome). PARTICIPANTS: All adults consecutively admitted with SAB...
April 17, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29658216/-prevention-of-urinary-tract-infection-in-the-elderly-what-s-new-in-long-term-care-facilities
#18
Sonia Lajoso, Marie Immaculée Nahimana Tessemo, Eve Rubli Truchard, Amel Rodondi, Christiane Petignat
Urinary tract infections are common in the elderly. They are a frequent reason for antibiotic prescription in nursing homes and hospitals. Doctors are confronted daily to the challenge that it is to diagnose urinary tract infections in older patients. The incidence of asymptomatic bacteriuria and the presence of unspecific symptoms and signs in this population transform guidelines for prevention and treatment into some kind of a battle. In this article we will : 1) make a reminder of the particular features of urinary tract infection in the elderly person ; 2) present the recommendations made by the experts and 3) emphasize the prevention of catheter-related urinary tract infection...
April 11, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29649696/cholecystitis-secondary-to-gallbladder-torsion-a-rare-case-report
#19
Jason Cui, Mariya Abdullah, Iman Awan, Daniel Mehanna
INTRODUCTION: Gallbladder torsion is a rare condition of increasing prevalence in recent years. It is often difficult to diagnose pre-operatively and delayed intervention can lead to significant complications. PRESENTATION OF CASE: We present a case of an 81 year old lady who presented with symptoms of cholecystitis for 24 h with no evidence of cholelithiasis on imaging. She deteriorated within 24 h of admission despite intravenous antibiotics; Emergency laparoscopy was performed which showed the gallbladder malrotated 180 ° with features of necrosis...
April 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29643543/-airway-foreign-body-caused-by-aspiration-of-artificial-nasal-sponge-a-case-report
#20
T X Fu, X Wang, M L Liu
57-year-old male was admitted to hospital for severe headache and seizure attacks on November 6th, 2016. After radiology and spinal fluid examination, he was diagnosed with viral encephalitis and treated with antiviral medicine, antibiotics and mannitol, but he was in sustained unconsciousness and weak in expectorating. The patient was given oxygen through artificial nasal after bedside tracheotomy. At 1:00 am on January 12th, 2016, there was a sudden drop in blood pressure, heart rate and oxygen saturation with left lung breath sounds slightly lower than the other side...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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