Comparative efficacy of oral contraceptive versus local treatment versus intense pulsed light combined with vacuum in endocrine acne in women.

Acne is the most common affection of adolescents, although it can be also found in adult women. Our study was aimed at the comparative assessment of three different therapies over a three-month period, applied to women with moderate comedogenic and papulo-pustular endocrine acne. In the study 116 female patients with endocrine localized face acne were included and divided into three groups: group I with 42 patients was treated with a combination of contraceptive pill + local treatment + pulsed-vacuum light; group II with 38 patients was treated with contraceptives and pulsed-vacuum light and group III with 36 patients was treated only with local treatment. The acne evaluation was made using the Global Acne Grading System (GAGS). Statistical data processing was carried out using the STATA software. For the comedogenic form of acne, the good and very good results were superior in group I vs group II and III (83.33% vs 31.58% vs 5.56%) at the end of the three months of treatment. For the papulo-pustulous form of acne, good and very good results were similar in groups I and II (92.86% vs 73.68%) both after the first month of treatment and at the end of the study, well above the local treatment group (13.99%). Our study highlighted the superiority of laser treatment combined with hormonal treatment, compared to hormonal and local treatment in the comedogenic form of acne, and the superiority of hormonal treatment combined (or not) with laser treatment in the papulo-pustular form compared to local treatment.

A Comparative Study on Antibiotic Resistance of Klebsiella Strains from Surgical and Intensive Care Wards.

INTRODUCTION: Klebsiella infections are common in Intensive Care Unit (ICU) and surgical wards. In order to establish the prophylaxis protocols, we must know the prevalence of infections and the antibiotic resistance profiles. MATERIAL AND METHODS: This cross-sectional study included isolates from patients in County Clinical Emergency County Hospital, Craiova, Romania: 1254 isolates from the ICU and 1040 isolates from surgical wards. We used an automated method (Phoenix analyzer, Becton-Dickinson, USA) with antimicrobial testing according to CLSI 2014. We tested by disc diffusion the ESBL and carbapenemases production, using kits ESBL Confirm ID and KPC/Metallo-beta-lactamase/OXA-48 Confirm (ROSCO Diagnostica, Denmark). The patients in ICU were also screened at admission for carbapenemase producting strains by PCR (GeneXpert® II, Cepheid, Sunnyvale, CA, USA) for the carbapenemases: KPC, IMP-1, VIM-1, NDM, OXA-48. RESULTS: Klebsiella strains were more prevalent in ICU (20.81%) vs. surgical wards (16.34%) and they were resistant in high percentages at: cefuroxime (95.81% vs. 87.21%),ceftazidime (91.70% vs. 84.71%), cefepime (84.2% vs. 69.82%). The highest differences in resistance were observed for Tygecycline (Risk Ratio (RR) = 7.69), Imipenem/Cilastatine (RR=3.36), Cefoperazone with sulbactam (RR=2.58), Ciprofloxacine (RR=2.11), Gentamycin (RR=2.05) and Ertapenem (RR=1.93). The ICU strains showed MDR in 48.57% of cases vs. 23.57% in surgery strains. The prevalence of ESBL production was 82.4% in ICU vs. 32.3% in surgical wards. The prevalence of carbapenemase producing strains was 43.68% in ICU vs. 23.53% in surgical wards. CONCLUSIONS: The infections with Klebsiella spp. are more frequent in ICU compared with surgical wards and their antibiotic resistance is greater.

Clinical relevance of vascular endothelial growth factor-A in colorectal cancer.

PURPOSE: To study the expression status and clinical relevance of vascular endothelial growth factor-A (VEGF-A) in colorectal cancer (CRC) tissues. EXPERIMENTAL DESIGN: VEGF-A expression was investigated by immunohistochemistry in 89 cases with CRC. Some demographic and histopathological variables were compared with VEGF-A expression to determine the prognostic significance in CRC. RESULTS: VEGF-A (-) was found in 24 cases; (+), (++) and (+++) stainings were detected in 24, 35 and six cases, respectively. VEGF-A (-) was found in 20 of 58 cases with left colon cancer, while only four of 31 cases with right colon cancer were VEGF-A (-) (p=0.024). There was a trend for lower tumor grade and lesser serosal invasion in cases with VEGF-A (-) samples (p=0.07 and p=0.079, respectively). Although the correlation was not statistically significant, there was a trend for lower death rate in cases with VEGF-A (-) tumor (p=0.087). The longest survival was found in cases with VEGF-A (-) tumor and the shortest survival was found in cases with VEGF-A (+++) tumor. Median survival for patients with VEGF-A (-), (+), (++) and (+++) tumors was 59, 47, 35 and 11 months, respectively (p=0.02). The Cox proportional hazards model identified stage IV disease and VEGF-A (+++) tumor as having the most important influences upon overall survival (odds ratio: 5.1, 95% confidence interval: 2.0-13.0 and odds ratio: 3.6, 95% confidence interval: 1.0-12.7, respectively), followed by serosal invasion (odds ratio: 2.4, 95% confidence interval: 1.0-5.9). CONCLUSIONS: This study shows that VEGF-A is a poor prognostic factor in cases with CRC, but the relatively small size of the study group precluded the correlation with the entire known prognostic indicator.