ABSTRACT
Hospital-acquired pneumonia (HAP) remains a significant cause of morbidity and attributable mortality, especially among patients undergoing mechanical ventilation. The clinical approach to this disorder continues to evolve. Although our understanding of the epidemiology, risk factors, and pathogenesis of this disorder are expanding, consensus on diagnostic, therapeutic, and preventive strategies is lacking. Although outcome is significantly improved by the rapid introduction of appropriate antimicrobial therapy, presently available diagnostic tests rarely are able to identify a specific pathogen when antimicrobial choices are made. Thus, most therapy is by necessity empirical. The American Thoracic Society (ATS) published guidelines for the empiric treatment of HAP in 1996, this article reviews the recommendations of these guidelines and, if new information is available, updates these recommendations.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Cross Infection/prevention & control , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/prevention & control , Cross Infection/diagnosis , Decision Trees , Humans , Pneumonia, Bacterial/diagnosis , Practice Guidelines as TopicABSTRACT
Twenty patients were divided into 2 groups. Group - A had 10 ASA Grade I while Group - B consisted of 10 asymptomatic patients with ECG evidence of ischaemia. One week of coronary dilator treatment was given to the patients in group-B before surgery. Intra operative cardioscopic monitoring was done in both the groups. In group-B, 5 patients showed ECG evidence of intraoperative myocardial ischaemia, and/or ventricular ectopics, which were in most cases attributable to anaesthetic/surgical stimuli but were not always associated with increased Rate pressure product. In group-A only one patient showed ECG evidence of ischaemia intraoperatively. It is therefore concluded that patients with optimal therapy for IHD continue to be at risk of intraoperative cardiovascular abnormalities.
Subject(s)
Coronary Disease/surgery , Intraoperative Complications , Myocardial Infarction/etiology , Atenolol/therapeutic use , Blood Pressure/physiology , Electrocardiography , Female , Humans , Intraoperative Complications/physiopathology , Intraoperative Complications/prevention & control , Male , Middle Aged , Myocardial Infarction/physiopathology , Myocardial Infarction/prevention & control , Nifedipine/therapeutic use , Pulse/physiology , Risk FactorsABSTRACT
A case of colloid cyst of the third ventricle in a patient presenting with delusional depressive syndrome, in clear consciousness and with minimal cognitive impairment, is reported. The possible pathogenesis of the syndrome is discussed in the light of the reported association between aqueduct stenosis, diencephalic dysfunction, hydrocephalus, and psychotic symptoms.
Subject(s)
Cerebral Ventricle Neoplasms/complications , Cysts/complications , Delusions/etiology , Adult , Female , Humans , Memory Disorders/etiologyABSTRACT
An open, multi-centre study was carried out in 69 patients with an acute psychotic episode to assess the efficacy and side-effects of treatment with oral zuclopenthixol dihydrochloride. Patients were treated until the acute episode was considered terminated by the clinician and, although dosage could be adjusted to allow optimum clinical response, the majority received 25 mg zuclopenthixol dihydrochloride 3-times daily throughout the trial period. Assessments were made before and during treatment using the BPRS and CGI rating scales and a check-list of side-effects. The results showed that 55 (80%) patients had a successful response to treatment. Almost half (33) of the patients responded fully to the drug within 3 weeks and by the end of 5-weeks' treatment this had increased to over 70% (49). A further 6 patients responded after 6 to 9 weeks of treatment. The drug was generally well tolerated and the majority of patients had either no side-effects or side-effects which did not overtly affect performance.
