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Matthew E Falagas

Publications and source records attributed to Matthew E Falagas.

At least 37 records · Page 2Linked to original sources
PubMed2006

Clinical decision-making based on findings presented in conference abstracts: is it safe for our patients?

Research findings presented in scientific conferences have a considerable direct and indirect impact on decision-making of clinicians. Investigators in various fields of research have examined the possible differences in aims, results, and conclusions between conference abstracts and subsequent corresponding published papers. They documented that differences between data presented in conference abstracts and published papers are frequent and occasionally major. These findings strongly support the position that we should not hurry to incorporate in clinical decision-making data presented at international or national scientific conferences. Instead, we believe that we better serve our patients by waiting at least for the evaluation of potential scientific advances by rigorous peer review.

Biomedical Research↗
PubMed2006

World Wide Web resources on antimicrobial resistance.

Advances of modern technology, including the development of the Internet and the World Wide Web, have given clinicians and researches the opportunity to have immediate access to continuously updated information in various scientific fields. We compiled a list of World Wide Web resources of data from surveillance studies on antimicrobial resistance that may be useful to practitioners--especially infectious diseases specialists--as well as to scientists with a research interest in the field of antimicrobial resistance.

Drug Information Services↗
PubMed2006

A prospective study of services utilization of a hospital-based employee health clinic.

BACKGROUND: Little is known regarding the utilization of services of a hospital-based employee health clinic (EHC). MATERIAL/METHODS: We evaluated the utilization of services of the EHC of a tertiary hospital in Greece. Demographic and clinical data were prospectively collected and analyzed for all employees who visited the EHC during a 24-month period (01/06/2003-31/05/2005). RESULTS: A total of 939 primary and 55 follow-up visits were recorded. Of all 994 visits, 419 were made by nurses (42%), 270 by administrative staff (27%), and only 15 visits by physicians (1%). Only 5.6% of physicians used the EHC during the study period (14 out of 252 doctors) whereas 35.4% of the nurses (218 out of 615) visited the EHC at least once (p<0.001). Three hundred and one of the rest 544 employees (55.3%) visited the EHC, significantly more than physicians (p < 0.001) and nurses (p<0.001). The majority of employees who visited the clinic were females (78%), while the most common reason for consultation was periodic evaluation accounting for 108 visits (11%), followed by abdominal pain (99 visits, 10%), dizziness (48 visits, 5%), and respiratory tract infections (44 visits, 5%). A significant reduction in the number of visits was observed after the 9(th) month of the study, coinciding with a change in the worker's health insurance policy (p<0.001). CONCLUSIONS: Periodic evaluations, abdominal pain, dizziness, respiratory tract infections, and weakness/malaise cover the bulk of consultation visits of a hospital-based EHC. Physicians were the group of employees that visited the EHC less often.

Adult↗
PubMed2006

Prevalence and predictors of tuberculin skin positivity in Hellenic Army recruits.

BACKGROUND: Tuberculosis (TB) remains one of the leading causes of death among infectious diseases worldwide. Despite its low incidence rates in countries of Western Europe and North America, the resurgence of TB in Eastern Europe and the increased immigration from high-incidence countries imply that extreme vigilance is required in order to detect early, treat, and isolate all new cases. In this study, we analyzed the prevalence and predictors of tuberculin skin testing positivity in Hellenic Army recruits. METHODS: The study population consisted of 953 Greek military recruits enlisted inthe Army during the period from November 2005 to February 2006. Tuberculin skin testing was performed on all study subjects upon enrollment, according to the routine procedures. A tuberculin skin test reaction size >15 mm was considered positive for all study participants. Epidemiological data regarding age, repatriation status, geographic area of residence, smoking habits, and parental occupation were collected by means of personal interviews. In addition, body weight, height, and body mass index were measured. RESULTS: The mean age of the studied subjects (+/- SD) was 23.5 (+/- 6.4) years. The overall prevalence of tuberculin positivity was 3.9% (37/953), and bivariable analysis showed that it was associated with lower weight (p = 0.047) and repatriation status (p < 0.001). Tuberculin skin testing was positive in 2.6% of natives (24/900) and 24.5% of repatriates (13/53). A backward, stepwise multivariable logistic regression model showed that only repatriation status was independently associated with tuberculin positivity (p < 0.001; odds ratio [OR]: 14.1; 95% confidence interval [CI]: 6.5-30.3). CONCLUSION: While the incidence of tuberculosis in the native Greek population is low, and comparable to other Western European countries, the extremely high tuberculin positivity in repatriated persons underscores the importance of actively screening for TB in order to promptly identify, isolate, and treat cases of active and latent infection.

Adolescent↗
PubMed2006

Probiotics for prevention of recurrent vulvovaginal candidiasis: a review.

Vulvovaginal candidiasis (VVC) is a common infection affecting the quality of life of many women. Probiotics have been investigated as possible agents for the prevention of recurrences of VVC. We reviewed the available literature. In some studies the development of VVC was associated with either a low number of lactobacilli in the vagina or with the presence of H2O2-non-producing vaginal lactobacilli, although there are a few studies not supporting these statements. In addition, in vitro studies have shown that lactobacilli can inhibit the growth of Candida albicans and/or its adherence on the vaginal epithelium. The results of some clinical trials support the effectiveness of lactobacilli, especially Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14, administered either orally or intravaginally in colonizing the vagina and/or preventing the colonization and infection of the vagina by C. albicans, while the results of a small number of clinical trials do not corroborate these findings. Nevertheless, most of the relevant clinical trials had methodological problems such as small sample size, no control group (placebo) and included women without confirmed recurrent VVC, and thus they are not reliable for drawing definitive conclusions. Thus, the available evidence for the use of probiotics for prevention of recurrent VVC is limited. However, the empirical use of probiotics may be considered in women with frequent recurrence of VVC (more than three episodes per year), especially for those who have adverse effects from or contraindications for the use of antifungal agents, since adverse effects of probiotics are very rare. In any case women should be clearly informed about the unproven usefulness of probiotics for this purpose. In conclusion, despite the promising results of some studies, further research is needed to prove the effectiveness of probiotics in preventing the recurrences of VVC and to allow their wide use for this indication.

Antibiosis↗
PubMed2006

Secular trends of antimicrobial resistance of blood isolates in a newly founded Greek hospital.

BACKGROUND: Antimicrobial resistance is one of the most challenging issues in modern medicine. METHODS: We evaluated the secular trends of the relative frequency of blood isolates and of the pattern of their in vitro antimicrobial susceptibility in our hospital during the last four and a half years. RESULTS: Overall, the data regarding the relative frequency of blood isolates in our newly founded hospital do not differ significantly from those of hospitals that are functioning for a much longer period of time. A noteworthy emerging problem is the increasing antimicrobial resistance of Gram-negative bacteria, mainly Acinetobacter baumannii and Klebsiella pneumoniae to various classes of antibiotics. Acinetobacter baumannii isolates showed an increase of resistance to amikacin (p = 0.019), ciprofloxacin (p = 0.001), imipenem (p < 0.001), and piperacillin/tazobactam (p = 0.01) between the first and second period of the study. CONCLUSION: An alarming increase of the antimicrobial resistance of Acinetobacter baumannii isolates has been noted during our study.

Anti-Bacterial Agents↗
PubMed2006

Linezolid for the treatment of patients with endocarditis: a systematic review of the published evidence.

BACKGROUND: Linezolid is a bacteriostatic oxazolidinone antibiotic that has been proven to be effective for the treatment of patients with pneumonia, skin and soft tissue infections, and possibly bacteraemia, due to Gram-positive cocci. However, the drug is sometimes used for the treatment of patients with endocarditis due to Gram-positive cocci resistant to other antibiotics. METHODS: We carried out a review of the available literature to evaluate whether linezolid is also effective for the treatment of patients with infective endocarditis. RESULTS: We identified 23 case reports and 3 case series reporting the experience with 56 patients with endocarditis treated with linezolid. Evaluable data for 33 patients who received linezolid and for whom individual patient data were reported were further analysed. Prosthetic valve infective endocarditis accounted for 25% of the reviewed cases. Methicillin-resistant Staphylococcus aureus and vancomycin-intermediate S. aureus were the most commonly isolated cocci (24.2% and 30.3% of cases, respectively). Linezolid alone was administered to 66.7% of patients while the rest received the antibiotic in combination with rifampicin, gentamicin, fusidic acid or amikacin. A total of 63.6% (21/33) of patients with endocarditis were cured after linezolid administration. The overall and endocarditis-related mortality was 33.3% (11/33) and 12.1% (4/33), respectively. Thrombocytopenia developed in 30.8% (8/26) of patients for whom relevant data were available. CONCLUSIONS: The limited available evidence suggests that linezolid may be considered as a therapeutic option for the treatment of patients with endocarditis due to multidrug-resistant Gram-positive cocci. However, further published experience is needed to answer the question of whether a bacteriostatic antibiotic could be proven beneficial for patients with an infection for which bactericidal antibiotics have been traditionally used.

Acetamides↗
PubMed2006

Limitations in the management of aortic graft infections.

The use of aortic allografts has emerged as a management option in patients with aortic graft infections. We present a patient with a history of Takayasu's disease whose aortic graft infection was controlled with replacement of the excised infected aortic graft with an allograft. However, the patient died 9 months later after the rupture of a large anastomotic aortic aneurysm. Our report emphasizes the limitations in the management of aortic graft infections in patients with extensive vascular disease such as Takayasu's disease. This is the result of difficulties in performing extra-anatomical bypass as well as a possibly increased risk of formation of anastomotic aneurysms in these patients.

Anastomosis, Surgical↗
PubMed2006

Oral rifampin for prevention of S. aureus carriage-related infections in patients with renal failure--a meta-analysis of randomized controlled trials.

BACKGROUND: Rifampin has been studied as prophylaxis against Staphylococcus aureus-related infections in patients on dialysis. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) that compared the effectiveness and safety of oral rifampin with another regimen or no therapy in reducing S. aureus-related infections in dialysis patients. RESULTS: Four RCTs evaluated oral rifampin (administered for 5 days every 3 months, or for 5 days once) as prophylaxis in dialysis patients. Oral rifampin with or without bacitracin was associated with less access-site infections with S. aureus compared with no treatment (odds ratio = 0.16, 95% confidence intervals: 0.06-0.44, 3 RCTs). There was no difference between prophylaxis with oral rifampin and topical mupirocin applied at the catheter site, for all studied outcomes, in the RCT comparing these regimens. Withdrawal from the study due to drug-related toxicity occurred in 7/107 (6.6%) of the studied patients with renal failure. Development of resistance of S. aureus to rifampin ranged from 0 to 18.2% (reported in three out of four included RCTs). CONCLUSION: Prophylactic use of oral rifampin reduces access-site infections with S. aureus in patients with renal failure undergoing dialysis. However, development of toxicity and antimicrobial resistance during the treatment with rifampin occur in considerable proportions of patients, limiting its use and supporting the guidelines that recommend the use of local antibiotics at the exit site, such as mupirocin, for these indications. The available data are rather limited and more studies should be performed to examine this important clinical question.

Administration, Oral↗
PubMed2006

Secular trends of blood isolates in patients from a rural area population hospitalized in a tertiary center in a small city in Greece.

BACKGROUND: Most of the studies evaluating the secular trends of blood isolates come from tertiary hospitals in urban areas. We sought to study the trends of the antimicrobial resistance of blood isolates in patients from a rural population hospitalized in a tertiary hospital in a small city in Greece. METHODS: We retrospectively collected and analysed data for the first positive blood culture obtained for each admission for each patient hospitalized in General Hospital of Tripolis, Tripolis, Peloponnesus, Greece during a 5 year period (16/05/2000-15/05/2005). RESULTS: Sixty-seven thousand and seventy patients were hospitalized during the study period from whom 3,206 blood cultures were obtained. A higher increase of the number of obtained blood cultures than the number of admissions was noted during the study period (p < 0.001). Three hundred and seventy-three (11.6%) blood cultures were positive. Coagulase-negative staphylococci (35.9%), Escherichia coli (29%), and Staphylococcus aureus (18.2%) were the most commonly isolated pathogens. Among the Staphylococcus aureus isolates, the proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 17.2% (5/29). The proportion of Escherichia coli resistant to trimethoprim and sulfamethoxazole, ampicillin and cefuroxime was 29.6% (32/108), 25.0% (27/108), and 8.3% (9/108) respectively. Imipenem-resistance was noted in 3.4% (1/29) of Pseudomonas aeruginosa isolates. There were only 6 (1.6%) Acinetobacter baummanii blood isolates during the study period. CONCLUSION: The antimicrobial resistance of isolates from patients receiving care at the studied tertiary hospital in a small city in Greece is considerably less compared to that noted in tertiary hospitals in larger cities of the country.

Bacteremia↗
PubMed2006

Comparison of mortality of patients with Acinetobacter baumannii bacteraemia receiving appropriate and inappropriate empirical therapy.

OBJECTIVES: To evaluate the effect of inappropriate empirical antimicrobial treatment on the mortality of patients with Acinetobacter baumannii bacteraemia. METHODS: Retrospective cohort study of patients with A. baumannii bacteraemia hospitalized at the Henry Dunant hospital from January 2002 to December 2004. RESULTS: Among 40 patients with A. baumannii bacteraemia, 22 (55%) and 18 (45%) received inappropriate and appropriate antibiotic therapy, respectively, during the 3 day period after obtaining the blood culture(s) from which the pathogen was isolated. Failure to cure the infection was more common in the first group [16/22 patients (72.7%) versus 5/18 (27.8%), P = 0.005]. Although without statistical significance, probably due to the small number of studied patients, considerably increased mortality was noted in the first group compared with the second group [13/22 patients (59.1%) versus 6/18 (33.3%), P = 0.10]. CONCLUSIONS: A. baumannii bacteraemia was associated with worse outcome regarding the cure of infection in patients who received inappropriate empirical antimicrobial treatment compared with those who received appropriate treatment.

Acinetobacter Infections↗
PubMed2006

A bibliometric analysis of research productivity in Parasitology by different world regions during a 9-year period (1995-2003).

BACKGROUND: The objective of this study was to estimate the research productivity of different world regions in the field of Parasitology. METHODS: Using the PubMed database we retrieved articles from journals included in the "Parasitology" category of the "Journal Citation Reports" database of the Institute for Scientific Information for the period 1995-2003. Research productivity was evaluated based on a methodology we developed and used in other bibliometric studies by analysing: (1) the total number of publications, (2) the mean impact factor of all papers, and (3) the product of the above two parameters, (4) the research productivity in relation to gross domestic product of each region, and (5) the research productivity in relation to gross national income per capita and population of each region. RESULTS: Data on the country of origin of the research was available for 18,110 out of 18,377 articles (98.6% of all articles from the included journals). Western Europe exceeds all world regions in research production for the period studied (34.8% of total articles), with USA ranking second (19.9%), and Latin America & the Caribbean ranking third (17.2%). The mean impact factor in articles published in Parasitology journals was highest for the USA (1.88). Oceania ranked first in research productivity when adjustments for both the gross national income per capita (GNIPC) and population were made. Eastern Europe almost tripled the production of articles from only 1.9% of total production in 1995 to 4.3% in 2003. Similarly, Latin America and the Caribbean and Asia doubled their production. However, the absolute and relative production by some developing areas, including Africa, is still very low, despite the fact that parasitic diseases are major public health problems in these areas. CONCLUSION: Our data suggest that more help should be provided by the developed nations to developing areas for improvement of the infrastructure of research.

Africa↗