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Biomedical subjects

G Kotsiou

Publications and source records attributed to G Kotsiou.

7 recordsLinked to original sources
PubMed2006

Spinal-injured neuropathic bladder antisepsis (SINBA) trial.

OBJECTIVE: To determine whether Methenamine Hippurate (MH) or cranberry tablets prevent urinary tract infections (UTI) in people with neuropathic bladder following spinal cord injury (SCI). STUDY DESIGN: Double-blind factorial-design randomized controlled trial (RCT) with 2 year recruitment period from November 2000 and 6 month follow-up. SETTING: In total, 543 eligible predominantly community dwelling patients were invited to participate in the study, of whom 305 (56%) agreed. METHODS: Eligible participants were people with SCI with neurogenic bladder and stable bladder management. All regimens were indistinguishable in appearance and taste. The dose of MH used was 1 g twice-daily. The dose of cranberry used was 800 mg twice-daily. The main outcome measure was the time to occurrence of a symptomatic UTI. RESULTS: Multivariate analysis revealed that patients randomized to MH did not have a significantly longer UTI-free period compared to placebo (HR 0.96, 95% CI: 0.68-1.35, P=0.75). Patients randomized to cranberry likewise did not have significantly longer UTI-free period compared to placebo (HR 0.93, 95% CI: 0.67-1.31, P=0.70). CONCLUSION: There is no benefit in the prevention of UTI from the addition of MH or cranberry tablets to the usual regimen of patients with neuropathic bladder following SCI.

Adolescent↗
PubMed1998

Choosing the right antibiotic.

BACKGROUND: With the increasing complexity of the antibiotic armamentarium and the increasing prevalence of resistance, the choice of an appropriate antibiotic is more difficult than ever before. There is also increasing concern that overuse of broad spectrum antibiotics may help reduce their effectiveness in the future. In attempting to make rational antibiotic choices, competing interests must be balanced in order to preserve one of our most powerful medical tools. OBJECTIVE: The aim of this paper is to discuss some of the factors that should be considered when selecting an antibiotic and to provide general principles for use in day to day decision making. DISCUSSION: A knowledge of the patient combined with a working knowledge of the likely target organism and its predicted susceptibility profile is the basis of antibiotic selection.

Anti-Bacterial Agents↗
PubMed1995

Mixed morphotype testing of Pseudomonas aeruginosa cultures from cystic fibrosis patients.

Bronchial secretions of patients with cystic fibrosis (CF) inevitably become colonised with Pseudomonas aeruginosa. This organism often exhibits multiple phenotypes with different antibiotic susceptibility profiles. Isolating each colonial morphotype and determining its antibiotic susceptibility profile is labour-intensive and time-consuming. Two disk diffusion methods for mixed morphotype susceptibility testing were examined; 134 morphotypes of P. aeruginosa from 50 respiratory specimens from CF patients were tested. Mixed cultures were prepared by (a) combining morphologically different colonies of P. aeruginosa directly from the sputum specimen primary culture plates from individual patients or (b) mixing colonies of individual morphotypes after isolation and subculture. Agreement with the results for testing morphotypes individually were 85.8% and 91.6%, respectively, for the two methods. These agreement rates rose to 95.6% and 99.4%, respectively, when minor errors (intermediate misclassified as susceptible or resistant or vice versa) were excluded. Mixed morphotype testing of P. aeruginosa directly from sputum specimen culture plates in chronically colonised CF patients is more efficient, reduces turn-around time and provides clinically meaningful information about antibiotic susceptibility.

Anti-Bacterial Agents↗
PubMed1994

Is hepatitis C serology reliable? Problems with clinical application.

OBJECTIVE: To describe some inherent difficulties in the interpretation of anti-hepatitis C virus (HCV) antibody testing. CLINICAL FEATURES: A 30-year-old carpark attendant sustained an accidental needlestick injury. The results of serological and biochemical investigations were suggestive of HCV infection but were not conclusive. INTERVENTION AND OUTCOME: Further testing was carried out on his stored sera in an attempt to establish a diagnosis. Two second generation enzyme-linked immunosorbent assay tests (Abbott and Ortho) gave differing results but were suggestive of seroconversion and subsequent seroreversion to HCV. Further testing with recombinant immunoblot assay and polymerase chain reaction did not resolve the issue. CONCLUSION: Our findings in this patient illustrate how the use of anti-HCV antibody tests in some clinical settings can result in confusion and misdiagnosis. These tests should be restricted to situations in which diagnostic usefulness has been established.

Adult↗