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antibiotics end of life

Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
A E Hoban, R D Moloney, A V Golubeva, K A McVey Neufeld, O O'Sullivan, E Patterson, C Stanton, T G Dinan, G Clarke, J F Cryan
Gut microbiota colonization is a key event for host physiology that occurs early in life. Disruption of this process leads to altered brain development which ultimately manifests as changes in brain function and behaviour in adulthood. Studies using germ-free mice highlight the extreme impact on brain health that results from life without commensal microbes, however the impact of microbiota disturbances occurring in adulthood is less studied. To this end, we depleted the gut microbiota of 10-week-old male Sprague Dawley rats via chronic antibiotic treatment...
October 11, 2016: Neuroscience
Paola Nóbrega Souza, Erique José Peixoto de Miranda, Ronaldo Cruz, Daniel Neves Forte
OBJECTIVE: To describe the characteristics of patients with HIV/AIDS and to compare the therapeutic interventions and end-of-life care before and after evaluation by the palliative care team. METHODS: This retrospective cohort study included all patients with HIV/AIDS admitted to the intensive care unit of the Instituto de Infectologia Emílio Ribas who were evaluated by a palliative care team between January 2006 and December 2012. RESULTS: Of the 109 patients evaluated, 89% acquired opportunistic infections, 70% had CD4 counts lower than 100 cells/mm3, and only 19% adhered to treatment...
September 2016: Revista Brasileira de Terapia Intensiva
Kaisa Rajala, Juho T Lehto, M Saarinen, E Sutinen, T Saarto, M Myllärniemi
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive disease with median survival from 2 to 7 years. Palliative care is an important part of patients´ care as lung transplantation is not an option for the majority of patients. The aim of this study was to describe treatment practices, decision-making and symptoms during end-of-life care of IPF patients. METHODS: We identified 59 deceased patients from a national prospective IPF cohort study (FinnishIPF) and analyzed retrospectively their health care documentation during the 6 months that preceded death...
October 12, 2016: BMC Palliative Care
Michał Ławiński, Karol Forysiński, Agnieszka Bzikowska, Justyna Z Kostro, Aleksandra Gradowska, Marek Pertkiewicz
INTRODUCTION: The ESPEN guidelines on long-term (> 3 months) parenteral nutrition recommend the use of tunnelled central venous catheters (CVCs) to minimise the risk of insertion site infection. A developed symptomatic infection of the soft tissue tunnel surrounding a CVC may rapidly become directly life threatening if the infection progresses along the catheter tunnel towards its end inserted into the venous system. This requires immediate management to eliminate infection and limit its effects...
2016: Przegla̜d Gastroenterologiczny
Vittorio Magri, Emanuele Montanari, Emanuela Marras, Gianpaolo Perletti
Although fluoroquinolones are first-line agents for the treatment of National Institutes of Health (NIH) category II chronic bacterial prostatitis (CBP), therapy with these agents is not always feasible due to the increasing worldwide resistance of causative uropathogens. New therapeutic options are urgently required, as drugs such as β-lactam antibiotics distribute poorly to prostatic sites of infection and trimethoprim therapy is often unfeasible due to high resistance rates. The present study aimed to analyze the efficacy of aminoglycosides, administered to a cohort of 78 patients affected by fluoroquinolone-resistant CBP, or excluded from fluoroquinolone therapy due to various contraindications...
October 2016: Experimental and Therapeutic Medicine
Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Maria Helde-Frankling, Jenny Bergqvist, Peter Bergman, Linda Björkhem-Bergman
BACKGROUND: The aim of this study was to elucidate whether palliative cancer patients benefit from antibiotic treatment in the last two weeks of life when an infection is suspected. METHOD: We reviewed medical records from 160 deceased palliative cancer patients that had been included in previous studies on vitamin D and infections. Patients treated with antibiotics during the last two weeks of life were identified and net effects of treatment (symptom relief) and possible adverse events were extracted from medical records...
September 6, 2016: Cancers
Sun Kyung Baek, Hye Jung Chang, Ja Min Byun, Jae Joon Han, Dae Seog Heo
Purpose: We explored the relationship between the use of each medical intervention and the length of time between DNR consent and death in Korea. Materials and Methods: A total of 295 terminal cancer patients participated in this retrospective study. Invasive interventions [e.g., cardiopulmonary resuscitation (CPR), intubation, and hemodialysis], less invasive interventions (e.g., transfusion, antibiotic use, inotropic use and laboratory tests), and the time interval between the DNR order and death were evaluated...
September 1, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Thomas L Holland, Larry M Baddour, Arnold S Bayer, Bruno Hoen, Jose M Miro, Vance G Fowler
Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with health care contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system...
2016: Nature Reviews. Disease Primers
Lyle L Pritchard
Cystic fibrosis (CF) is an autosomal recessive genetic disease that occurs in approximately 1 in 2,500 white live births. It is less common in nonwhite individuals. A dysfunctional epithelial chloride channel leads to excessively thick mucus affecting multiple organ systems. Common issues include mucous plugging of the airway, lung inflammation, chronic pulmonary infections, intestinal malabsorption, and malnutrition. Universal screening of newborns for CF is recommended in many countries. CF can be diagnosed based on clinical evidence of disease along with genetic testing or other laboratory evidence of chloride channel dysfunction...
September 2016: FP Essentials
Lars Schröder, Gerhard Hommel, Stephan Sahm
BACKGROUND: Despite a recent statutory ruling stating the binding nature of advance directives (ADs), only a minority of the population has signed one. Yet, a majority deem it of utmost importance to ensure their wishes are followed through in case they are no longer able to decide. The reasons for this discrepancy have not yet been investigated sufficiently. PATIENTS AND METHODS: This article is based on a survey of patients using a well-established structured questionnaire...
2016: Patient Preference and Adherence
Ilias Karaiskos, Maria Souli, Irene Galani, Helen Giamarellou
INTRODUCTION: Living in the 'era of antibiotic resistance' and facing the threat of an 'end to antibiotics', physicians in the last decade have revived use of colistin, since the available literature at the clinical level was poor and limited Areas covered: Herein, the authors present the current available knowledge regarding colistin, i.e. in vitro activity and interactions, current pharmacokinetics/pharmacodynamics (PK/PD), clinical efficacy against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacteria, as well as toxicity issues, whereas the recently published newer plasmid mediated mcr-1 resistance gene is reviewed and discussed...
August 30, 2016: Expert Opinion on Drug Metabolism & Toxicology
Tine D Clausen, Thomas Bergholt, Olivier Bouaziz, Magnus Arpi, Frank Eriksson, Steen Rasmussen, Niels Keiding, Ellen C Løkkegaard
BACKGROUND: Studies link antibiotic treatment and delivery by cesarean section with increased risk of chronic diseases through changes of the gut-microbiota. We aimed to evaluate the association of broad-spectrum antibiotic treatment during the first two years of life with subsequent onset of childhood type 1 diabetes and the potential effect-modification by mode of delivery. MATERIALS AND METHODS: A Danish nationwide cohort study including all singletons born during 1997-2010...
2016: PloS One
Y Yuan, Z M Sun, Y Zhang, F F Liang, X X He
OBJECTIVE: To establish a rat model of nonalcoholic fatty liver disease (NAFLD) using high-fat diet, and to dynamically observe the influence of the changes in gut microbiota on the development and progression of NAFLD in rats during and after modeling. METHODS: Sprague-Dawley rats were given high-fat diet to establish the model of NAFLD, and these rats were randomly divided into high-fat group, antibiotic pretreatment group, antibiotic treatment group, restricted diet group, and control group...
May 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
T Batool, P L Reece, K M Schulze, K M Morrison, S A Atkinson, S S Anand, K K Teo, J A Denburg, M M Cyr
Prenatal and early-life environmental exposures play a key role in the development of atopy and allergic disease. The Family Atherosclerosis Monitoring In earLY life Study is a general, population-based Canadian birth cohort that prospectively evaluated prenatal and early-life traits and their association with atopy and/or allergic disease. The study population included 901 babies, 857 mothers and 530 fathers. Prenatal and postnatal risk factors were evaluated through questionnaires collected during the antenatal period and at 1 year...
July 25, 2016: Journal of Developmental Origins of Health and Disease
Jamie Wood, Siobhain Mulrennan, Kylie Hill, Nola Cecins, Sue Morey, Sue Jenkins
INTRODUCTION: A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. METHODS: Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention...
July 20, 2016: Journal of Telemedicine and Telecare
Karen Harrison Dening, Michael King, Louise Jones, Victoria Vickestaff, Elizabeth L Sampson
BACKGROUND AND AIMS: When a person with dementia (PWD) has lost the ability to make treatment decisions, clinicians often rely on family carers to know and articulate these preferences with assumed accuracy. This study used the Life Support Preferences Questionnaire (LSPQ) to explore whether family carers' choices show agreement with the end of life care preferences of the person with dementia for whom they care and what factors influence this. METHODS: A cross-sectional study interviewing 60 dyads (a person with early dementia and preserved capacity and their family carer) each completing a modified LSPQ...
2016: PloS One
M Cardona-Morrell, Jch Kim, R M Turner, M Anstey, I A Mitchell, K Hillman
PURPOSE: To investigate the extent of objective 'non-beneficial treatments (NBTs)' (too much) anytime in the last 6 months of life in routine hospital care. DATA SOURCES: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-April 2015). STUDY SELECTION: All study types assessing objective dimensions of non-beneficial medical or surgical diagnostic, therapeutic or non-palliative procedures administered to older adults at the end of life (EOL)...
September 2016: International Journal for Quality in Health Care
Lukasz Dziki, Michal Mik, Radzislaw Trzcinski, Jaroslaw Buczynski, Anna Kreisel, Mariusz Skoneczny, Adam Dziki
INTRODUCTION: In cases of haemorrhoidal disease resistant to conservative treatment, surgical treatment is necessary to relieve the symptoms. AIM: To investigate the current methods used by Polish surgeons. MATERIAL AND METHODS: Surveys were distributed to members of the Association of Polish Surgeons (APS), in which participants were asked a number of closed-ended questions regarding haemorrhoidal disease and the way they treated suffering patients...
2016: Przegla̜d Gastroenterologiczny
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