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Biomedical subjects

A Corona

Publications and source records attributed to A Corona.

At least 19 recordsLinked to original sources
PubMed2006

Short-course monotherapy strategy for treating bacteremia in the critically ill.

AIM: Routine practice in the ICU of University College London (UCL) Hospitals is to use short course (5-6 days) monotherapy, unless contraindicated (e.g. endocarditis, osteomyelitis). The aim of this study is to assess our policy by monitoring the clinical response, relapse rate and patient outcome. METHODS: A prospective observational study was carried out from February to July 2000. Clinically significant bacteraemia was identified by daily prospective surveillance of all positive blood cultures. On all the patients we recorded: 1) demographics; 2) antibiotic therapy (type, duration) and ACCP/SCCM sepsis criteria; 3) ICU support techniques (e.g. mechanical ventilation, intravascular catheter changes); 4) development of further bacteraemia or relapses. For all positive results, Gram stain, identification and antibiotic sensitivity patterns were noted. SPSS software was used for statistical analyses. RESULTS: Out of 713 admitted to the ICU over the study period, 84 (8.2%) patients experienced 102 bacteraemic episodes: 14 community-, 28 hospital- and 60 ICU-acquired (occurring in 49 patients). A total of 78 (76.4%) episodes [8 (57%) community-, 22 (79%) hospital- and 48 (80%) ICU-acquired] were treated with short course monotherapy. Moreover a low rate (23.8%) of death directly related to the bacteraemia and a satisfactory (72%) clinical response were recorded. ICU-acquired multidrug resistant Gram-negative bacteraemias (6.5%) and fungaemias (3%) were also uncommon. No patient discharged from the ICU, subsequently developed either bacteraemia relapse, or any long-term related complication. CONCLUSIONS: Short course antibiotic monotherapy strategy appears to provide a satisfactory clinical response, low relapse rate and no long-term infectious complications. Multicentre studies are warranted to confirm the efficacy of our practice.

Aged↗
PubMed2005

Aggressive dream content without daytime aggressiveness in REM sleep behavior disorder.

BACKGROUND: REM sleep behavior disorder (RBD) is characterized by vigorous sleep motor activity associated with dream mentation. Patients with RBD frequently report action-filled and violent dreams. OBJECTIVE: To systematically assess dream characteristics and daytime aggressiveness in patients with RBD and controls. METHODS: Forty-nine patients with polysomnographic-confirmed RBD diagnosis and 71 age- and sex-matched controls were asked to recall the most recent dreams and to complete the Aggression Questionnaire (AQ). Forty-one patients with RBD (81.6%; 36 men, 5 women; mean age: 67.5 +/- 7.5 years) and 35 controls (49.3%; 30 men, 5 women; mean age: 69.1 +/- 5.9 years) were able to remember their dreams and a total of 98 (RBD) and 69 (controls) dreams were collected in the two groups. Verbatim dream descriptions were scored and analyzed according to the Hall and Van De Castle method. RESULTS: Patients with RBD showed a higher percentage of dream with at least one aggressive episode (DWA) than controls (66% vs 15%; p < 0.00001), a higher aggression/friendliness interaction ratio (86% vs 44%; p < 0.0001), and a greater frequency of animal characters (19% vs 4%; p = 0.0001). In contrast to controls, no patient with RBD had dreams with elements of sexuality (0% vs 9%; p < 0.0001). The two groups did not differ in total AQ scores, except for a lower score on the physical aggressiveness subscale in patients with RBD compared to control subjects (16.5 +/- 6.4 vs 20.4 +/- 8.3; p = 0.034). No correlation was observed between dream aggressiveness and age, duration, or frequency of RBD symptoms. CONCLUSIONS: Dreams in patients with REM sleep behavior disorder were characterized by an elevated proportion of aggressive contents, despite normal levels of daytime aggressiveness. Dreams with aggressiveness and the known excessive phasic muscle activity during REM sleep may be related to the hyperactivity of a common neuronal generator.

Aged↗
PubMed2004

Prevention of nosocomial infection in the ICU setting.

The aim of this review is to focus the epidemiology and preventing measures of nosocomial infections that affect the critically ill patients. Most of them (over 80%) are related to the device utilization needed for patient life support but responsible for such complications as ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSI), surgical site infections (SSI) and urinary tract infections (UTI). General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. The routine changing of central catheters is not necessary and increases costs; it is necessary to decrease the handling of administration sets, to use a more careful insertion technique and less frequent set replacement. Specific measures for VAP prevention are: 1). use of multi-use, closed-system suction catheters; 2). no routine change of the breathing circuit; 3). lubrication of the the endotracheal tube cuff with a water-soluble gel; 4). maintenance of patient in semi-recumbent position to improve chest physiotherapy. Specific measures for UTI prevention include: 1). use of a catheter-valve instead of a standard drainage system; 2). use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. By implementing effective preventive measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

Catheterization↗
PubMed2003

Inhibitory activity of spices and essential oils on psychrotrophic bacteria.

This study was designed to evaluate "in vitro" the inhibitory effects of spices and essential oils on the growth of psycrotrophic food-borne bacteria: Aeromonas hydrophila, Listeria monocytogenes and Yersinia enterocolitica. The sensitivity to nine spices and their oils (chilli, cinnamon, cloves, ginger, nutmeg, oregano, rosemary, sage, thyme) was studied. Antibacterial activity was evaluated on liquid and solid medium. Spices: 1% concentration of each spice was added separately to Triptic Soy Broth and then inoculated to contain 10(8)/ml organism and held to 4 degrees C for 7 days. Populations of test organism were determined on Triptic Soy Agar. Oils: Inhibition of growth was tested by using the paper disc agar diffusion method (at 35, 20 and 4 degrees C) and measuring their inhibition zone. MIC was determined by the broth microdilution method. Some culinary spices produce antibacterial activity: inhibition of growth ranged from complete (cinnamon and cloves against A. hydrophila) to no inhibition. Antibacterial inhibition zone ranged from 8 mm to 45 mm: thyme essential oil showed the greatest inhibition against A. hydrophila.

Aeromonas hydrophila↗
PubMed2003

[Infection control and prevention in intensive care: environmental aspects].

Surveillance is understood as the monitoring over time of the onset of preventable infection and/or microbial colonization in patients in intensive care units (ICU), where the prevalence of nosocomial infections, particularly those caused by microorganisms multiresistant to antibiotics, is alarmingly high. Surveillance deals with: 1) pathogens responsible for infection and their patterns of antibiotic resistance; 2) epidemics; 3) endemic infections selected according to predictability; 4) frequency of use of specific invasive procedures, where the greater the use, the higher the frequency of nosocomial infections associated with them; 5) use of antibiotics. Surveillance is operated through: 1) the microbiology laboratory, which is responsible for accurate surveillance of hospital infections; 2) the active surveillance on the wards, which concerns: a) identification of infections either on admission or during hospitalization or both, b) use of invasive procedures, control of parameters, and data collection, c) type of patients treated, identification of infected patients and data analysis and interpretation. Infection prevention complementary to surveillance starts with the adoption of strategies and interventions based on the application of universal precautions and/or on the route of transmission. A crucial point is the sterilization and disinfection of medical devices. In recent years there has been a steady rise in the number of infections caused by medical devices, most likely because of the increasing use of sophisticated and complex equipment that is often difficult to decontaminate and because of the rise in the number of immunocompromised patients or those susceptible to infections.

Critical Care↗
PubMed2000

Epibenthic amphipod abundance and predation efficiency of the pink shrimp Farfantepenaeus duorarum (Burkenroad, 1939) in habitats with different physical complexity in a tropical estuarine system.

Amphipod abundance and biomass were determined in soft-bottom substrates (SBS), monospecific Thalassia testudinum patches and T. testudinum with attached macroalgae (SAV) from Términos Lagoon. Amphipods were absent in SBS, and their density and biomass were higher in SAV (3351 individualsm(-2), 1718 mg AFDWm(-2)) than in T. testudinum (1220 indm(-2), 625 mg AFDWm(-2)). Although macroalgae and seagrasses are recognised as an alternative refuge against predation for amphipods, the high abundance of amphipods in SAV suggests that macroalgae represent a habitat that provides greater food availability. Pink shrimp Farfantepenaeus duorarum (Burkenroad, 1939) consumption rate (Mo) of epibenthic amphipods was experimentally evaluated. Mo intensifies as prey density increases and varied from 0.39 to 2.39 mg AFDWh(-1). Predation efficiency of F. duorarum on epibenthic amphipods was also evaluated in four artificial habitats with different physical complexity: soft-bottom substrates (SBS), small woody debris (SWD), seagrasses with densities of 300 and 1200 shootsm(-2) (S300 and S1200, respectively), macroalgae (MA), and at two prey densities (962 and 2406 indm(-2)). Amphipod consumption rate by F. duorarum varied from 1.20 to 2.07 indh(-1) in S1200 and MA, respectively. Habitat complexity had a significant effect on consumption rate, but prey density did not. Habitat physical complexity and predation efficiency maintained an inverse and a non-linear relationship. Presumably, the decrease in predation efficiency in association with the habitat complexity is due to the differential refuge value of these habitats. However, predation efficiency may also be influenced by either the microhabitat use by amphipods, the shrimp's dependence on seagrasses, or by differences in habitat value caused by the diel behavioural distribution pattern of amphipods and shrimp. Both field and experimental results highlight the importance of evaluating the relative value of tropical estuarine habitats through the study of the relationship between habitat physical complexity and predator-prey interactions. They also emphasise that inherent biological and ethological factors of the predator and prey involved, coupled to spatial and temporal variations in the habitat, should also be considered.

Journal Article↗
PubMed1999

The therapy of amblyopia: an analysis comparing the results of amblyopia therapy utilizing two pooled data sets.

CONTEXT: We previously presented the results of an original pooled data set of 961 amblyopic patients who underwent patching therapy for amblyopia from 1965 to 1994 (study group 1). Three types of amblyopia were considered: anisometropic, anisometropic-strabismic, and strabismic. Analysis of this group's success was related to the age at which therapy was initiated, the type of amblyopia, and the depth of visual loss before treatment was begun. The purpose of the current study is to test the validity of these findings on a second group of 961 amblyopes employing the data set used by Woodruff and associates in their publications (study group 2). These 2 data sets, after adjustment to conform to the definitions of age, amblyopia, anisometropia, and similar items utilized in common between the 2 study groups, will be compared for the risk factors predictive of successful occlusion therapy. OUTCOME: As in the previous study, the success of occlusion therapy is defined as a visual acuity of 20/40 or better at the end of treatment. RESULTS: Success by the 20/40 criteria was achieved in 73.7% in study group 1 and in 59.9% in study group 2. By category, the rate of success in study group 1 was 77.2% in strabismic amblyopia, 67.2% in anisometropic-strabismic amblyopia, and 66.0% in anisometropic amblyopia. In study group 2, success was 61.2% in strabismic amblyopia, 51.2% in anisometropic-strabismic amblyopia, and 63.0% in anisometropic amblyopia. Study group 1 univariate analysis related success in each group to the age at which therapy was initiated, the type of amblyopia, and the depth of visual loss before treatment in each group. In study group 2, univariate analysis related success of occlusion therapy to age and the depth of visual loss before treatment. Type of amblyopia was not related to outcome success in this group. When the 2 data sets were pooled, the risk factors for success were age and depth of visual loss at onset of treatment. CONCLUSIONS: Factors that appeared closely related to a successful outcome of patching therapy were patient age and depth of visual loss before treatment. These conclusions further support the value of early detection and screening for amblyopia, its prevention, where possible, and its adequate and vigorous treatment when it is detected and diagnosed.

Amblyopia↗
PubMed1998

The therapy of amblyopia: an analysis of the results of amblyopia therapy utilizing the pooled data of published studies.

CONTEXT: Although the treatment of amblyopia with occlusion has changed little over the past 3 centuries, there is little agreement about which regimes are most effective and for what reasons. OBJECTIVE: To determine the outcome of occlusion therapy in patients with anisometropic, strabismic, and strabismic-anisometropic amblyopia employing the raw data from 961 patients reported in 23 studies published between 1965 and 1994. DESIGN: Analysis of the published literature on amblyopia therapy results during the above interval, utilizing primary data obtained from the authors of these articles or tables published in the articles detailing individual patient outcomes. PARTICIPANTS: 961 amblyopic patients, participants in 23 studies, undergoing patching therapy for amblyopia from 1965 to 1994 with anisometropia, strabismus, or anisometropia-strabismus. MAIN OUTCOMES: In the pooled data set, success of occlusion therapy was defined as visual acuity of 20/40 at the end of treatment. RESULTS: Success by the 20/40 criteria was achieved in 512 of 689 (74.3%) patients. By category, 312 of 402 (77.6%) were successful in strabismic amblyopia, 44 of 75 (58.7%) in strabismic-anisometropic amblyopia, and 72 of 108 (66.7%) in anisometropic amblyopia. Success was not related to the duration of occlusion therapy, type of occlusion used, accompanying refractive error, patient's sex, or eye. Univariate analyses showed that success was related to the age at which therapy was initiated; the type of amblyopia; the depth of visual loss before treatment for the anisometropic patients and the strabismic patients, but not for the anisometropic-strabismic patients; and the difference in spherical equivalents between eyes, for the anisometropic patients. Logistic/linear regression revealed that 3 were independent predictors of a successful outcome of amblyopia therapy. CONCLUSIONS: Factors that appear most closely related to a successful outcome are age, type of amblyopia, and depth of visual loss before treatment. These may be related to factors, as yet undetermined in the pathogenesis of amblyopia. With present emphasis on the value of screening and prevention and the development of new screening tools, such a look at the results of amblyopia therapy in a large population seems indicated.

Adolescent↗