scholarly journals Reasons for Choice of Antibiotic for the Empirical Treatment of CAP by Canadian Infectious Disease Physicians

1999 ◽  
Vol 10 (5) ◽  
pp. 337-345 ◽  
Author(s):  
Jacob Pendergrast ◽  
Thomas Marrie
Keyword(s):  
Infectious Disease ◽  
Decision Making ◽  
Pneumococcal Infection ◽  
Generation Cephalosporin ◽  
Community Acquired Pneumonia ◽  
Empirical Treatment ◽  
Prescribing Practices ◽  
The Third ◽  
First Case ◽  
Respondent Characteristics

BACKGROUND: Previous studies have documented substantial variation in physician prescribing practices for the treatment of community-acquired pneumonia. Much of this variation is the result of empirical treatment, in which physicians must choose antibiotics in the a8bsence of culture and sensitivity data.OBJECTIVE: To explore the factors that influence antibiotic choice for the empirical treatment of community-acquired pneumonia.MATERIALS AND METHODS: Case-based questionnaires were mailed to all 157 members of the Canadian Infectious Disease Society in June 1996. The questionnaires presented three clinical cases and asked respondents which antibiotics they would most likely prescribe. Half the questionnaires were closed-ended, and half were open-ended. In the former, respondents were asked to explain their antibiotic choice by assigning weights to a list of clinical factors. In the latter, respondents were asked to explain their antibiotic choice by providing a short written answer. Respondents were grouped by the class of antibiotics they selected. These groups were then compared with regards to respondent characteristics (age, years of infectious disease experience, adult versus pediatric practice, country of training, province of practice) and rationale for the treatment chosen. Rationale for drug choice was analyzed statistically for the closed-ended questionnaires and qualitatively for the open-ended questionnaires.RESULTS: A response rate of 84.6% was obtained. For the first clinical case, in which the patient was young and had no underlying illness, the majority of respondents chose a macrolide (74.7%). In the second case, in which the patient was older and had evidence of comorbidity, the most common choice of antibiotic was a penicillin (40.8%). In the third case, in which the patient had intensive care unit-requiring pneumonia, the most popular choice was combination therapy of a third-generation cephalosporin and a macrolide (43.2%). There was decreasing consensus regarding the choice of antibiotics as the complexity of the cases increased. There was evidence that prescribing variation could occasionally be attributed to both respondent characteristics and the use of different decision-making strategies.CONCLUSIONS: Despite the relative homogeneity of the physicians studied, considerable variation in antibiotic choice was observed. In the first case, this variation was based on the issue of whether the patient had a typical or atypical infection. In the second case, the choice of antibiotic was related to the issue of infection byHaemophilus influenzae, although the results of the Gram stain suggested a pneumococcal infection. In the third case, variance appeared to be based more on the respondent’s age and province of practice than on any difference in decision-making strategy.

scholarly journals Food and beverage stocks responding to COVID-19

2021 ◽  
Vol 18 (3) ◽  
pp. 359-371
Author(s):  
Lai Cao Mai Phuong
Keyword(s):  
Decision Making ◽  
Event Study ◽  
Stock Prices ◽  
Policy Implications ◽  
Market Theory ◽  
The Third ◽  
First Case ◽  
Event Study Method ◽  
Food And Beverage ◽  
Efficient Market Theory

This paper investigated how food and beverage (F&B) stocks react to COVID-19. The event study method was applied to four events including the first and second events, were the first COVID-19 positive patients detected in the largest and second-largest economic center of Vietnam. The third and fourth events are related to strong measures to prevent the spread of COVID-19: the nationwide lockdown at the beginning of the second quarter of 2020, and the lockdown of Danang at the beginning of the third quarter of 2020. The results show that the reaction of F&B stock prices to events supports the semi-strong form of efficient market theory. The strong and lasting negative reaction of F&B stocks to the first event can be explained by surprise (first case in Vietnam) and Hochiminh city’s economic engine driving role in the development of Vietnam’s economy. The study finds that heuristic decision-making from nationwide lockdowns (suppression of supply chains during lockdowns) can explain the sub-sector of farming-fishing-ranching products reacted more strongly to the lockdown event in Danang. Based on the research results, this paper provides some policy implications for managers and notes for securities investors.

STRATEGI MAKSIMALISASI ANGGARAN BELANJA PADA BALAI PENELITIAN DAN PENGEMBANGAN LINGKUNGAN HIDUP DAN KEHUTANAN MANOKWARI

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Arif Hasan ◽  
Dedi Budiman Hakim ◽  
Irdika Mansur
Keyword(s):  
Decision Making ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Primary Data ◽  
Fiscal Year ◽  
The Third ◽  
Swot Matrix ◽  
Three Stages ◽  
Using Data

This study aims to analyze causes of the low uptake of the budget and formulate a strategy of maximizing the absorption of expenditure on Balai Penelitian dan Pengembangan Lingkungan Hidup dan Kehutanan Manokwari. Respondents involved are 20 people that consist of: treasury officials and holder output of activity. The data used were secondary data in the form of reports on budget realization (LRA) quarter I, II, III and IV of the fiscal year 2011 to 2015, and the primary data were in the form of interviews with the help of a questionnaire. While the analysis of the data used was descriptive analysis using data tabulation, and the analysis of the three stages strategy of the decision making used IFE and EFE matrix, SWOT matrix and QSPM matrix.The results showed that there are 19 factors causing low of budget absorption until the end of the third quarter, and there were 10 drafts of policy as a strategy for maximizing the absorption of the budget on Balai Penelitian dan Pengembangan Lingkungan Hidup dan Kehutanan Manokwari.ABSTRAKPenelitian ini bertujuan untuk menganalisis penyebab rendahnya penyerapan anggaran belanja dan merumuskan strategi maksimalisasi penyerapan anggaran belanja pada Balai Penelitian dan Pengembangan Lingkungan Hidup dan Kehutanan Manokwari. Responden yang terlibat adalah 20 orang yaitu pejabat perbendaharaan dan pemegang output kegiatan. Data yang digunakan adalah data sekunder berupa laporan realisasi anggaran (LRA) triwulan I, II, III dan IV tahun anggaran 2011 sampai 2015, dan data primer berupa wawancara dengan bantuan kuesioner. Sedangkan analisis data yang digunakan adalah analisis deskriptif menggunakan analisis tabulasi, dan analisis analisis strategi tiga tahap pengambilan keputusan menggunakan matriks IFE dan EFE, matriks SWOT dan matriks QSPM. Hasil penelitian menunjukkan bahwa terdapat 19 faktor penyebab rendahnya penyerapan anggaran belanja sampai akhir triwulan III, dan terdapat 10 rancangan kebijakan sebagai strategi maksimalisasi penyerapan anggaran belanja di Balai Penelitian dan Pengembangan Lingkungan Hidup dan Kehutanan Manokwari.

Penile Lymphoepithelioma-Like Carcinoma: A Rare Case With PD-L1 Expression

2021 ◽  
pp. 106689692098834
Author(s):  
Raquel Machado-Neves ◽  
Bernardo Teixeira ◽  
Elsa Fonseca ◽  
Pedro Valente ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Tumor Cells ◽  
Rare Case ◽  
Malignant Tumors ◽  
Squamous Cell Carcinomas ◽  
The Third ◽  
The Past ◽  
First Case ◽  
Lymphoplasmacytic Infiltrate

Most malignant tumors of the penis are squamous cell carcinomas (SCC), being divided in 2 groups, one human papillomavirus (HPV)-related and another non-HPV-related, with lymphoepithelioma-like carcinoma (LELC) being one of the rarest HPV-related SCC. In this article, we report a case of a 50-year-old man who presented testicular swelling and pain for the past 3 months. A penile mass was identified, and the patient was submitted to a total penectomy. The penectomy specimen showed an ulcerated lesion at the glans reaching the cavernous bodies. Microscopic examination showed undifferentiated epithelial cells with syncytial growth pattern mix with a dense lymphoplasmacytic infiltrate, consistent with LELC. The tumor cells expressed p16 and all 3 different clones of PDL1 (22C3, SP263, and SP142). The patient is alive and well with a follow-up of 3 months. To our knowledge, this is the third LELC of the penis reported in literature and the first case reported with PDL1 expression.

Pricing of Connected and Autonomous Vehicles in Mixed-Traffic Networks

2021 ◽  
pp. 036119812098585
Author(s):  
Paolo Delle Site
Keyword(s):  
Autonomous Vehicles ◽  
Marginal Cost ◽  
User Behavior ◽  
Social Planner ◽  
Traffic Networks ◽  
Mixed Traffic ◽  
The Third ◽  
First Case ◽  
Marginal Cost Pricing ◽  
The Social

For networks with human-driven vehicles (HDVs) only, pricing with arc-specific tolls has been proposed to achieve minimization of travel times in a decentralized way. However, the policy is hardly feasible from a technical viewpoint without connectivity. Therefore, for networks with mixed traffic of HDVs and connected and autonomous vehicles (CAVs), this paper considers pricing in a scenario where only CAVs are charged. In contrast to HDVs, CAVs can be managed as individual vehicles or as a fleet. In the latter case, CAVs can be routed to minimize the travel time of the fleet of CAVs or that of the entire fleet of HDVs and CAVs. We have a selfish user behavior in the first case, a private monopolist behavior in the second, a social planner behavior in the third. Pricing achieves in a decentralized way the social planner optimum. Tolls are not unique and can take both positive and negative values. Marginal cost pricing is one solution. The valid toll set is provided, and tolls are then computed according to two schemes: one with positive tolls only and minimum toll expenditure, and one with both tolls and subsidies and zero net expenditure. Convergent algorithms are used for the mixed-behavior equilibrium (simplicial decomposition algorithm) and toll determination (cutting plane algorithm). The computational experience with three networks: a two-arc network representative of the classic town bypass case, the Nguyen-Dupuis network, and the Anaheim network, provides useful policy insight.

Overview of recent cases before the Court of Justice of the European Union (November 2020-March 2021)

2021 ◽  
pp. 138826272110092
Author(s):  
Pauline Melin
Keyword(s):  
Parental Leave ◽  
The European Union ◽  
Framework Agreement ◽  
The Third ◽  
Court Of Justice ◽  
Rest Periods ◽  
First Case ◽  
Family Benefits ◽  
Grand Chamber ◽  
Italian Legislation

In this reporting period (November 2020-March 2021), five cases will be presented. The first case is INPS v WS (C-302/19), dealing with the Italian legislation that excludes Single Permit holders from receiving family benefits for their family members residing in a third country. In the second report, two cases rendered on the same day by the Grand Chamber of the Court are discussed. In D.J. v Radiotelevizija Slovenija (C-344/19) and RJ v Stadt Offenbach am Main (C-580/19), the Court clarified the circumstances under which periods of stand-by time could be considered as ‘working time’ or, alternatively, ‘rest periods’ under Directive 2003/88. XI v Caisse pour l’avenir des enfants (C-129/20) is the third case reported. It concerns an interpretation of the Framework Agreement on parental leave in the light of the Luxembourg legislation, which requires parents to be employed at the time of their child’s birth to benefit from parental leave. Finally, the case report ends with VL v Szpital Kliniczny im. dra J. Babińskiego Samodzielny Publiczny Zakład Opieki Zdrowotnej w Krakowie (C-16/19), a case of discrimination on grounds of disability.

scholarly journals Drug Induced Pneumonitis Secondary to Treatment with Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir (VIEKIRA PAK®) for Chronic Hepatitis C: Case Report of an Unexpected Life-Threatening Adverse Reaction

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Shih Yea Sylvia Wu ◽  
Bridget Faire ◽  
Edward Gane
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Final Diagnosis ◽  
Community Acquired Pneumonia ◽  
Drug Induced ◽  
First Case ◽  
Life Threatening

VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis. One week into treatment with VIEKIRA PAK without ribavirin, she was admitted to hospital with respiratory distress and acute kidney injury requiring intensive care input. She was initially diagnosed with community acquired pneumonia and improved promptly with intravenous antibiotics and supported care. No bacterial or viral pathogens were cultured. Following complete recovery, she recommenced VIEKIRA PAK but represented 5 days later with more rapidly progressive respiratory failure, requiring intubation and ventilation, inotropic support, and haemodialysis. The final diagnosis was drug induced pneumonitis.

Low-Grade Mucosa-Associated Lymphoid Tissue Lymphoma Involving the Kidney: Report of 3 Cases and Review of the Literature

2006 ◽  
Vol 130 (1) ◽  
pp. 86-89 ◽  
Author(s):  
Libo Qiu ◽  
Pamela D. Unger ◽  
Robert W. Dillon ◽  
James A. Strauchen
Keyword(s):  
Lymphoid Tissue ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphoid Cells ◽  
Low Grade ◽  
The Third ◽  
First Case ◽  
Abundant Cytoplasm ◽  
History Of

Abstract Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue involving the kidney is rare. We report a series of 3 cases. The first case occurred in an 83-year-old woman who presented with back pain. The second case was a 53-year-old man with a history of sarcoidosis who was found, in the course of evaluation of sarcoidosis, to have a right renal mass. The third case occurred in a 72-year-old man who had a history of periorbital mucosa–associated lymphoid tissue lymphoma and had been treated with surgery and radiation 1 year prior to this presentation. Histologically, all 3 patients showed infiltrate of uniform small-to-medium–sized lymphocytes with irregular nuclear contours and abundant cytoplasm resembling centrocytes or monocytoid lymphoid cells. The first patient received chemotherapy without complications. The second patient underwent a partial nephrectomy and was asymptomatic at the subsequent follow-up. The third patient developed a pulmonary embolism following nephrectomy, and further follow-up is not available.

Approach to dyspnoea in pregnancy in the COVID-19 era

2020 ◽  
Vol 19 (4) ◽  
pp. 230-234
Author(s):  
Anita Banerjee ◽  
◽  
Lindsay A Arrandale ◽  
Srividhya Sankaran ◽  
Guy W Glover ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Case Series ◽  
Differential Diagnoses ◽  
Shared Decision ◽  
First Case ◽  
Compromise Design ◽  
A Current ◽  
In Pregnancy

Importance: Dyspnoea and hypoxia in pregnant women during the COVID-19 pandemic may be due to causes other than SARS Co-V-2 infection which should not be ignored. Shared decision-making regarding early delivery is paramount. Objective: To highlight and discuss the differential diagnoses of dyspnoea and hypoxia in pregnant women and to discuss the risks versus benefit of delivery for maternal compromise. Design, setting and participants: Case series of two pregnant women who presented with dyspnoea and hypoxia during the COVID-19 pandemic. Results: Two pregnant women presented with dyspnoea and hypoxia. The first case had COVID-19 infection in the 3rd trimester. The second case had an exacerbation of asthma without concurrent COVID-19. Only the first case required intubation and delivery. Both recovered and were discharged home. Conclusion and relevance: Our two cases highlight the importance of making the correct diagnosis and timely decision-making to consider if delivery for maternal compromise is warranted. Whilst COVID-19 is a current healthcare concern other differential diagnoses must still be considered when pregnant women present with dyspnoea and hypoxia.

scholarly journals Abdominal angiostrongyliasis: report of two cases with different clinical presentations

2008 ◽  
Vol 50 (6) ◽  
pp. 339-341 ◽  
Author(s):  
Rubens Rodriguez ◽  
Roberta Martins Dequi ◽  
Lucas Peruzzo ◽  
Paulo Moacir Mesquita ◽  
Errol Garcia ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Acute Abdomen ◽  
Mesenteric Ischemia ◽  
Liver Involvement ◽  
Surgical Specimen ◽  
Ileal Perforation ◽  
Clinical Forms ◽  
Serum Igg ◽  
First Case ◽  
Clinical Presentations

Abdominal angiostrongyliasis is a sporadic infectious disease caused by the nematode Angiostrongylus costaricensis. It usually presents as acute abdomen, secondary to mesenteric ischemia, and pronounced eosinophilia. In some cases its course is insidious and transient, and the diagnosis is suspicious. The disease is confirmed by the detection of A. costaricensis elements in surgical specimen. The treatment is supportive, with avoidance of antihelminthic administration due to a possible erratic migration followed by worsening of the disease. We report two cases, both with intense eosinophilia and serum IgG-ELISA positive to A. costaricensis. The first case presented ileal perforation and was surgically treated. The second one showed hepatic nodules at ultrasound and was only symptomatically treated, evolving to an apparent protracted resolution. These two cases exemplify different clinical forms of the disease, one of them with liver involvement.

Sign in / Sign up

Export Citation Format

Share Document