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1.
Clin Hematol Int ; 3(2): 69-71, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34595468

RESUMO

The coronavirus disease 2019 (COVID-19) is a pandemic with a high rate of hospitalization, admission to intensive care units, and mortality. Identifying patients at the highest risk for severe disease is important to facilitate early, aggressive intervention. High red blood cell distribution width (RDW) values are associated with increased mortality in the general population in patients suffering from several conditions, including cardiovascular disease, sepsis, acute kidney injury, chronic obstructive pulmonary disease, and hepatitis B. Our study aimed to determine whether RDW levels in all COVID-19 confirmed cases admitted to the Patras University Hospital, Greece, was an independent prognostic factor of hospitalization and disease outcome.

2.
J Glob Infect Dis ; 5(1): 31-3, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23599616

RESUMO

A rare case of an abdominal aortic aneurysm (AAA) infected by Listeria monocytogenes in a 72-year-old male diabetic farmer, is reported. Our patient had a history of a recent pneumonia that could have been caused by Listeria too. Aneurysm infection was manifested by fever and abdominal and back pain, which prompted investigation with CT scanning that revealed a 4.9 cm AAA with typical signs of infection. He underwent urgent AAA repair with aortobifemoral bypass grafting and had an uneventful course. Aneurysm content microbiology revealed Listeria monocytogenes and following a 9-week course of antibiotics our patient remains asymptomatic 11 months later.

3.
Braz. j. infect. dis ; 15(5): 426-435, Sept.-Oct. 2011. ilus, tab
Artigo em Inglês | LILACS | ID: lil-612700

RESUMO

OBJECTIVES: Both total antimicrobial use and specific antimicrobials have been implicated as risk factors for healthcare-associated methicillin-resistant Staphylococcus aureus (HCA-MRSA) infection. The aims of this study were: (I) to explore predictors of a new HCA-MRSA infection in comparison with a new healthcare-associated methicillin-sensitive Staphylococcus aureus (HCA-MSSA); (II) to thoroughly assess the role of recent antibiotic use qualitatively and quantitatively. METHODS: The time-period for our study was from October 1997 through September 2001. Through applying strict criteria, we identified two groups of inpatients, one with a new HCA-MRSA infection and one with a new HCA-MSSA infection. We recorded demographic, clinical and antibiotic use-related data up to 30 days before the positive culture date. RESULTS: We identified 127 and 70 patients for each group, respectively. Two logistic regression models were carried out to assess the role of antimicrobial use (qualitatively and quantitatively). In model I, duration of hospital stay, presence of chronic wounds, aminoglycoside and fluoroquinolone use retained statistical significance. In model II, duration of hospital stay and history of intubation during the last month stood out as the only significant predictors of a subsequent HCA-MRSA infection. No significant differences in outcome were noted. CONCLUSIONS: The length of exposure to the hospital environment may be the best predictor of a new HCA-MRSA infection. Use of aminoglycosides and fluoroquinolones may also stand independently along with presence of chronic ulcers and surgical procedures. No independent association between quantitative antibiotic use and subsequent HCA-MRSA infection was documented.


Assuntos
Idoso , Feminino , Humanos , Masculino , Antibacterianos/administração & dosagem , Infecção Hospitalar/microbiologia , Exposição Ambiental/efeitos adversos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Infecção Hospitalar/transmissão , Exposição Ambiental/estatística & dados numéricos , Intubação/efeitos adversos , Tempo de Internação , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/transmissão , Staphylococcus aureus/efeitos dos fármacos , Ferimentos e Lesões/microbiologia
4.
Braz J Infect Dis ; 15(5): 426-35, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22230848

RESUMO

OBJECTIVES: Both total antimicrobial use and specific antimicrobials have been implicated as risk factors for healthcare-associated methicillin-resistant Staphylococcus aureus (HCA-MRSA) infection. The aims of this study were: (I) to explore predictors of a new HCA-MRSA infection in comparison with a new healthcare-associated methicillin-sensitive Staphylococcus aureus (HCA-MSSA); (II) to thoroughly assess the role of recent antibiotic use qualitatively and quantitatively. METHODS: The time-period for our study was from October 1997 through September 2001. Through applying strict criteria, we identified two groups of inpatients, one with a new HCA-MRSA infection and one with a new HCA-MSSA infection. We recorded demographic, clinical and antibiotic use-related data up to 30 days before the positive culture date. RESULTS: We identified 127 and 70 patients for each group, respectively. Two logistic regression models were carried out to assess the role of antimicrobial use (qualitatively and quantitatively). In model I, duration of hospital stay, presence of chronic wounds, aminoglycoside and fluoroquinolone use retained statistical significance. In model II, duration of hospital stay and history of intubation during the last month stood out as the only significant predictors of a subsequent HCA-MRSA infection. No significant differences in outcome were noted. CONCLUSIONS: The length of exposure to the hospital environment may be the best predictor of a new HCA-MRSA infection. Use of aminoglycosides and fluoroquinolones may also stand independently along with presence of chronic ulcers and surgical procedures. No independent association between quantitative antibiotic use and subsequent HCA-MRSA infection was documented.


Assuntos
Antibacterianos/administração & dosagem , Infecção Hospitalar/microbiologia , Exposição Ambiental/efeitos adversos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Idoso , Infecção Hospitalar/transmissão , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Intubação/efeitos adversos , Tempo de Internação , Masculino , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/transmissão , Staphylococcus aureus/efeitos dos fármacos , Ferimentos e Lesões/microbiologia
5.
J Arthroplasty ; 25(7): 1078-82, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20381287

RESUMO

This is a prospective randomized study comparing cefuroxime to 2 antistaphylococal agents (fusidic acid and vancomycin), for prophylaxis in total hip arthroplasty (THA) and total knee arthroplasty (TKA) in an institute, where methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) prevalence exceeds 25% of orthopedic infections. There were 3 patient groups. Group A included the patients who received cefuroxime, group B those who received fusidic acid, and group C those who received vancomycin. Patients were evaluated for the presence of superficial and/or deep infection at the surgical site. Statistical analysis did not reveal any substantial difference between the 3 groups. We do not recommend the use of specific antistaphylococcal agents for prophylactic use in primary THA and TKA, even in institution where MRSA and MRSE exceed 25% of orthopedic infections.


Assuntos
Antibacterianos/uso terapêutico , Artroplastia de Quadril , Artroplastia do Joelho , Cefuroxima/uso terapêutico , Ácido Fusídico/uso terapêutico , Infecções Relacionadas à Prótese/prevenção & controle , Vancomicina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Prótese de Quadril/microbiologia , Humanos , Incidência , Prótese do Joelho/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Relacionadas à Prótese/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/prevenção & controle , Staphylococcus epidermidis/isolamento & purificação , Resultado do Tratamento
7.
Med Sci Monit ; 13(7): CS83-7, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17599031

RESUMO

BACKGROUND: Descending necrotizing mediastinitis (DNM) is a life-threatening complication secondary to oropharyngeal abscesses, esophageal perforation, or neck infections spreading into the mediastium, but very uncommon after thyroidectomy. Early diagnosis and close clinical and laboratory monitoring are crucial for patient survival. CT scanning of the cervical and thoracic area is a useful tool for diagnosis and follow-up. Different surgical approaches in the management of DNM have been proposed, the most widely accepted being a combined cervicotomy with lateral thoracotomy procedure. CASE REPORT: A rare case of DNM with group A ss-hemolytic streptococci, in a 47-year-old patient developing after thyroidectomy for multinodular goiter is presented. A more conservative approach through a cervical incision was followed and thoracic drains for pleural effusion evacuation were inserted. After re-operation, repeated CT scanning for disease progression and prompt surgical wound cleaning were performed. Antibiotic therapy was continued up to one month after release. The patient's recovery was uneventful and continues well. CONCLUSIONS: To the best of the authors' knowledge this is the second case of post-thyroidectomy DNM reported. According to present data it is recommend that a less invasive approach could be satisfactory when prompt diagnosis is established and the thoracic drainage is effective. This case suggests that repeated postoperative CT scanning and close clinical and laboratory monitoring could make an additional thoracotomy a second-line procedure. Moreover, due to the fact that only two cases of post-thyroidectomy DNM are reported worldwide, therapy of this condition remains an open question.


Assuntos
Mediastinite/terapia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Aorta Torácica/patologia , Meios de Contraste/farmacologia , Progressão da Doença , Feminino , Bócio Nodular/cirurgia , Humanos , Doenças do Mediastino/diagnóstico por imagem , Mediastinite/diagnóstico por imagem , Mediastinite/patologia , Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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