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1.
Cancers (Basel) ; 15(3)2023 Feb 02.
Article in English | MEDLINE | ID: mdl-36765895

ABSTRACT

Documenting bacteremia at the onset of fever in immunosuppressed children is challenging; therefore, it leads to the early administration of broad-spectrum antibiotics. We aimed to analyse the evolution of antibiotic resistance profiles of bacterial bloodstream infections (BSI) and gut colonisations in a large cohort of immunocompromised children carrying a central venous catheter, in comparison with a prior, similar study conducted in our centre from 2014 to 2017. A retrospective, observational cohort study was conducted from January 2018 to December 2021, in a tertiary centre for paediatric immuno-haematology and oncology. Empirical antibiotic therapy was adapted to the immunosuppression risk group and prior bacterial colonisation. There was a mean of 6.9 BSI/1000 patient bed days. Multidrug-resistant bacteria (MDRB) associated BSI accounted for 35/273 (12.8%). The incidence of MDRB gum/gut colonisation and MDRB associated BSI increased annually and correlated with the level of immunosuppression (p = 0.024). One third (34.7%) of the BSI episodes were not associated with neutropenia. As compared to the previous study, an alarming emergence of MDRB responsible for gut colonisations and BSI in immunosuppressed children was reported over the last four years. The degree of immunosuppression directly correlates with the risk of having an MDRB gut colonisation or MDRB BSI.

2.
Rom J Ophthalmol ; 63(4): 327-338, 2019.
Article in English | MEDLINE | ID: mdl-31915730

ABSTRACT

Objective. This study aimed to determine the possible relationship between variability of diabetic macular edema associated with hypertension retinopathy in patients with type 2 diabetes mellitus and essential high blood pressure, in correlation with contrast sensitivity. Material and Methods. In order to accomplish the objective, this retrospective study evaluated the progression of diabetic macular edema in patients with high blood pressure during day time through measurements of the total macular volume and central macular thickness using optical coherence tomography and contrast sensitivity variations measured through Pelli Robson test, four times a day, along with glycemia and blood pressure measurements. Results. Our results showed a statistically significant correlation between the values of glycemia and central macular thickness, and between contrast sensitivity and macular thickness at every tested hour. Conclusions. The study revealed many statistically significant correlations involving blood pressure, blood glucose levels, Pelli Robson test and central macular thickness. Abbreviations: OCT = optical coherence tomography; DME = diabetic macula edema; SD-OCT = spectral domain optical coherence tomography; LOCS = lens opacities classification system; LE = left eye; ANOVA = analysis of variance.


Subject(s)
Blood Pressure/physiology , Contrast Sensitivity/physiology , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis , Essential Hypertension/complications , Macula Lutea/pathology , Macular Edema/diagnosis , Aged , Aged, 80 and over , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/blood , Diabetic Retinopathy/complications , Essential Hypertension/physiopathology , Female , Follow-Up Studies , Humans , Macular Edema/etiology , Male , Middle Aged , Prospective Studies , Tomography, Optical Coherence/methods
3.
Rom J Ophthalmol ; 63(4): 354-359, 2019.
Article in English | MEDLINE | ID: mdl-31915733

ABSTRACT

Objective. This study followed the variability in the foveal avascular zone (FAZ) area measured using optical coherence tomography angiography (OCTA) in patients with type 2 diabetes mellitus and high blood pressure. Material and Methods. This prospective, non-randomized, cohort study evaluated 46 eyes in 26 patients with high blood pressure associated with diabetic non-proliferative retinopathy (mild, medium, and severe forms) and diabetic proliferative retinopathy. Results. Our results showed early macular alterations (microaneurysms, leakage, neovascularizations, intraretinal microvascular abnormalities), a higher class of severity despite a relatively normal clinical aspect and higher values of FAZ associated with neovascularization undetected by SD-OCT (spectral domain-OCT). Conclusion. Measurement of the foveal avascular zone area using OCTA early detects macular alterations that precede classical retinography and SD-OCT determinations. Abbreviations: FAZ = foveal avascular zone; OCTA = optical coherence tomography angiography; IRMA = intraretinal microvascular abnormalities; SD-OCT = spectral domain-optical coherence tomography; OU = both eyes; PD = papillary diameter; ETDRS = early treatment diabetic retinopathy study; BP = blood pressure; OD = right eye.


Subject(s)
Blood Pressure/physiology , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis , Essential Hypertension/complications , Fluorescein Angiography/methods , Fovea Centralis/pathology , Retinal Vessels/pathology , Tomography, Optical Coherence/methods , Diabetes Mellitus, Type 2/diagnosis , Diabetic Retinopathy/etiology , Essential Hypertension/physiopathology , Follow-Up Studies , Fovea Centralis/blood supply , Fundus Oculi , Humans , Prospective Studies
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