scholarly journals The effect of antibiotic timing on culture yield in paediatric osteoarticular infection

2019 ◽  
Vol 13 (1) ◽  
pp. 114-119 ◽  
Author(s):  
M. van der Merwe ◽  
K. Rooks ◽  
H. Crawford ◽  
C. M. A. Frampton ◽  
M. J. Boyle

Purpose To assess the influence of antibiotic timing on surgical culture yield in paediatric patients with haematogenous osteoarticular infection. Methods All patients aged 0 to 15 years admitted to a National Children’s Hospital with the diagnosis of acute, haematogenous, osteoarticular infection (osteomyelitis and/or septic arthritis) between June 1997 and December 2016 were retrospectively analyzed. Only patients with positive blood cultures undergoing surgery for culture and debridement were included. Patients were allocated into pre-treatment and post-treatment groups, according to whether they received antibiotics before or after surgical cultures were obtained. Outcomes measured included baseline variables, treatment characteristics and surgical culture yield. Results A total of 131 patients were included; 107 patients in the pre-treatment group and 24 patients in the post-treatment group. There was no significant difference with respect to patient age (p = 0.870), white blood cell count (p = 0.197), ethnicity (p = 0.203) or infection multi-focality (p = 0.883) between the two groups. The administration of systemic antibiotics prior to obtaining surgical cultures had no clinically significant effect on surgical culture yield (rate of positive surgical cultures, 85% (pre-treatment) versus 54.2% (post-treatment); p = 0.002). Within the pre-treatment group, there was no significant difference in duration of pre-surgical antibiotic treatment between patients who had positive or negative surgical cultures (mean duration, 45.9 hours (positive cultures) versus 47.9 hours (negative cultures); p = 0.743). Conclusion In paediatric patients with acute, haematogenous, osteoarticular infection, antibiotic administration before surgery does not decrease surgical culture yield. Our results suggest that paediatric patients presenting with suspected osteoarticular infection should receive appropriate systemic antibiotics promptly after blood cultures are obtained. Level of Evidence Level III - retrospective case-control study

2020 ◽  
pp. 112067212096345
Author(s):  
Marco Lupidi ◽  
Ramkailash Gujar ◽  
Alessio Cerquaglia ◽  
Jay Chhablani ◽  
Daniela Fruttini ◽  
...  

Purpose: To quantitatively assess retinal neovascularizations (RNVs) in proliferative diabetic retinopathy (PDR) before and after photocoagulative laser treatment (PLT) using Optical Coherence Tomography Angiography (OCT-A). Methods: Consecutive patients with PDR were examined with fluorescein angiography (FA) and OCT-A before and after PLT. Baseline and after-treatment FA images were quantitatively analyzed to assess both the RNVs area and leakage area. On OCT-A RNVs area, vascular perfusion density (VPD), vessel length density (VLD) and fractal dimension were computed. VPD of the full-retina OCT-A underneath the RNV was determined to evaluate potential laser-induced changes in vascular perfusion. Results: Fifteen eyes of 13 patients with PDR were enrolled. The mean area of the RNVs was 0.47 ± 0.50 mm2 in the baseline OCT-A and 0.32 ± 0.40 mm2 in the post-treatment assessment ( p = 0.0002). The mean RNV VPD of RNV was 2% ± 4% in pre-treatment and 1% ± 1% for the post-treatment ( p = 0.0001). The mean VLD of RNV was 7.26 ± 1.53 at baseline and 6.64 ± 1.65 in the post treatment ( p = 0.0002). A significant difference in terms of mean RNVs area and VPD reduction between eyes that needed additional treatment and those that did not (~40% vs ~20%; p < 0.05), was observed. Mean VPD of full-retinal thickness OCT-angiogram was 55% ± 10% for the pre-treatment and 53% ± 8% for the post treatment scan ( p = 0.02). Conclusion: The quantitative OCT-A assessment of laser-induced changes of RNVs can be a useful non-invasive approach for determining treatment efficacy. A reduction of RNVs area or VPD ⩾ 40% might reveal those eyes that won’t require additional treatment. Retinal perfusion impairment seemed to progress independently from the treatment.


2017 ◽  
Vol 46 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Jessica Lima ◽  
Hanna McCabe-Bennett ◽  
Martin M. Antony

Background: The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. Aims: It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. Method: Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. Results: There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. Conclusions: Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.


1971 ◽  
Vol 16 (4) ◽  
pp. 224-227 ◽  
Author(s):  
A. Balfour Sclare ◽  
J. K. Grant

A longitudinal study of urinary 17-OHCS in 16 depressive patients showed mean values within the accepted normal range. There were no significant differences between pre-treatment and post-treatment values; only the female patients showed a tendency to have somewhat lower post-treatment levels. 17-KS output was measured in 18 depressive patients. The mean values were within the normal range. There was no significant difference between pre-treatment and post-treatment values although the female patients displayed a tendency towards somewhat lower levels following treatment. DHA and EA excretion were measured in 9 depressive patients. There was a very wide variance in the findings. There was no significant difference between pre-treatment and post-treatment levels. The significance of the above findings is discussed. It is considered that measurements of urinary excretion of corticosteroids in affective disorders constitute a limited source of information.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P90-P90
Author(s):  
Osama Alhamarneh ◽  
Nicholas D. Stafford ◽  
John Greenman

Problem To determine the correlation between IL10, a Th2-type inhibitory cytokine, clinical outcome and survival in HNSCC patients. Methods IL10 levels in the serum of newly-presenting, untreated, patients with HNSCC were measured pre-treatment (n=107) and 4–6 weeks after treatment (n=43), and were compared with a cohort of healthy controls (n=40) of similar age and sex. A commercial IL10 ELISA (Biosource) with a minimum detectable level of 0.2 pg/ml was used. Statistical analysis of associations between the levels and detectability of IL10 and clinical outcome and survival were done. Results Both IL10 detectability and levels were significantly higher in patients than in controls (p=0.001). Post treatment, IL10 levels dropped significantly (p=0.02). Pretreatment, IL10 levels were significantly elevated in the advanced stage of the disease (III/IV vs. I/II), in node positive patients and in patients with bulkier tumor load (T3/T4 vs. T1/T2); p=0.005, 0.037 and 0.001 respectively. The larynx (n=36), oropharynx (n=25) and pharynx (n=16) showed significantly higher levels and increased detectability of IL10 in the pre-treatment group when compared to the post treatment group, however, oral cavity tumors (n=21) showed the opposite. Finally, the detectability of IL10 significantly correlated with poorer survival (Kaplan-Meier, p=0.026) after a mean follow up of 15 (range 1–36) months. Conclusion IL10 levels drop significantly once the tumor mass is removed suggesting that this is the most important source of the circulating cytokine. IL10, as well as the tumor bulk, the nodal status and the overall tumor stage, were shown to be independent factors in predicting a poorer clinical outcome and worse survival in tumors originating in the larynx, pharynx and oropharynx, but not oral cavity, suggesting distinct inter-tumour differences. Significance IL10 could play a potential role as a prognostic marker in HNSCC, in addition to the possible manipulation of IL10 in future immunotherapeutic agents.


2021 ◽  
Vol 15 (6) ◽  
pp. 2005-2010
Author(s):  
Seyyed Hassan Saadat ◽  
Khodabakhsh Ahmadi

Background: The present study was aimed at evaluating the effect of on-demand caffeine consumption on treating patients with premature ejaculation (PE compared to squeezing technique. Methods: In this non-blind RCT, 42 otherwise healthy individuals with PE were divided into 2 groups of caffeine and squeezing technique group. The former received 100 mg of encapsulated caffeine for 3 weeks, 2 hours prior to each intercourse. Intra-vaginal ejaculation latency time and index of sexual satisfaction were calculated before and after treatment in both groups. Results: Mean age of the participants was 39.48±7.62 years. Despite the fact that there was no significant difference between pre-treatment and post-treatment values of both IELT and ISS between our 2 groups, significant difference was seen in both groups between pre-treatment and post-treatment values. Furthermore, no strong correlation was seen in pre-treatment IELT and ISS; however, statistically significant correlation was found in post-treatment values. Conclusion: Regarding the fact that caffeine is a well-known and widely-used drug in common disease, the use of this compound is highly unlikely to bear any stigma. Our study demonstrates that 100 mg of on-demand caffeine can equally increase both IELT and ISS significantly as squeezing technique. Further investigations are needed. Keywords: caffeine, premature ejaculation, squeezing technique, intra-vaginal ejaculation latency time, index of sexual satisfaction,


Author(s):  
Nefise Kandemir ◽  
Sercan Kenanoglu ◽  
Murat Gultekin ◽  
Nuriye Gokce ◽  
Hilal Akalin ◽  
...  

Background Essential tremor (ET) is the most common movement disorder. Propranolol is a first-line medication for ET. We aimed to evaluate the effect of propranolol on the expression of poly (ADP-ribose) polymerase 1 (PARP1) and DNA polymerase beta (POLB) genes, which are known to be related to neurodegenerative diseases, in patients with ET. MethodsThirty-five healthy volunteers and thirty-five patients followed up with essential tremors were included in a non-randomized control experimental study. Expressions of PARP1 and POLB genes were compared between the control group and the patient group. In addition, pre- and post-treatment gene expression levels and Fahn-Tolosa-Marin tremor scale values of the patient group were compared after 8 weeks of propranolol treatment. The Wilcoxon rank and Mann Whitney U tests were used to analyze the data. ResultsAt baseline, PARP1 expression was significantly lower in the ET group than in the control group. (p<0.001). POLB gene expression was significantly higher in the pre-treatment ET group than in the controls (p<0.05). There was no significant difference in PARP1 expression levels before and after 8 weeks of propranolol treatment. POLB gene expression was significantly higher in the pre-treatment group than in the post-treatment group (p<0.001). ConclusionPropranolol significantly decreased POLB gene expression but there was no significant difference in PARP1 gene expression levels in the patient group, after 8 weeks of propranolol treatment.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaojuan Zhang ◽  
Hong Zhou ◽  
Xiangling Liao ◽  
Yi Liu

Abstract Background To evaluate the difference in root resorption between standard torque self-ligating brackets and high torque self-ligating brackets in bimaxillary protrusion patients after orthodontic treatment. Methods Pre-treatment and post-treatment Cone beam computed tomography (CBCT) of 32 patients (16 treated with the high torque DamonQ 0.022″ bracket and 16 with the 0.022″ standard torque self-ligating bracket) were selected. The first premolars were extracted from all patients before treatment. After mini-screw implants were inserted into the buccal region between the second premolar and first molar, 150 g of force was applied to retract the upper and lower anterior teeth to close the extraction space on each side. CBCT images of all patients were taken before and after treatment. Three-dimensional reconstruction of the maxillary central incisor, lateral incisor and canine was conducted with Mimics 20.0 software. The volumes of the roots were calculated using Gomagics Studio 12.0 software. The differences between the pre-treatment and post-treatment root volumes were statistically evaluated with a paired-samples t-test. Results There was no statistically significant difference in root resorption degree between the two kinds of torque brackets. The patient’s degree of root resorption in the high torque self-ligating group was greater than that in the standard torque group. Conclusions There was no significant difference in root external apical resorption between the high torque self-ligating brackets and the standard torque self-ligating brackets in bimaxillary protrusion patients.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18560-18560
Author(s):  
J. L. Ryan ◽  
C. Figueroa-Moseley ◽  
C. Bole ◽  
J. T. Hickok ◽  
L. K. Colman ◽  
...  

18560 Background: Cancer patients may experience skin problems while undergoing treatment. Frequency of skin reactions may be influenced skin pigmentation and/or psychological factors. Methods: A Symptom Inventory (SI) completed by 411 cancer patients nationwide before and after treatment was analyzed to determine if treatment type, race (Black versus White), and pre-treatment expectations influenced post-treatment skin reactions. Subsequent analysis of a SI completed weekly for five weeks by 167 local patients receiving radiotherapy examined severity of reported skin reactions. Results: One-way between-group ANOVA, with Bonferroni correction, showed significantly more patients receiving radiotherapy had stronger expectations of skin problems (62%) compared to patients receiving chemotherapy (40%, p = 0.001) or chemotherapy plus radiotherapy (45%, p = 0.003). Overall, expectations did not correlate with patient reported skin problems post-treatment (Spearman’s rho = 0.02, p = 0.70). Likewise, a Kruskal Wallis test showed no significant difference in severity of skin reactions reported by patients receiving radiotherapy (n = 138) and/or chemotherapy (n = 273, p = 0.56). Severe skin problems were reported more frequently by 10/18 (56%) Blacks than 90/393 (23%) Whites (p = 0.001), although no significant difference was found between Blacks and Whites in their pre-treatment expectations of skin problems (p = 0.32). Further, pre-treatment expectations of skin problems did not influence post-treatment reporting of skin problems in Blacks (Spearman’s rho = −0.02, p = 0.93) or Whites (Spearman’s rho = 0.02, p = 0.65). Similarly, the local study showed that significantly more Blacks (38%) reported severe skin reactions at the treatment site than Whites (6%). Total radiation exposure was significantly related to the severity of skin problems reported by Blacks (Spearman’s rho = 0.90, p = 0.04), but not Whites (Spearman’s rho = −0.06 p = 0.52). Conclusions: Overall, Blacks reported more severe post-treatment skin problems than Whites. How this self-reported skin damage correlates with clinical findings remains to be determined. Supported by NCI PHS grants 1R25CA102618 and U10CA37420. No significant financial relationships to disclose.


2017 ◽  
Vol 22 (5) ◽  
pp. 75-82 ◽  
Author(s):  
Ezgi Atik ◽  
Tülin Taner

ABSTRACT Objective: The aim of this study was to compare the longitudinal stability of the conventional straight-wire system after the use of a quad-helix appliance with Damon self-ligating system in patients with Class I malocclusion. Methods: 27 adolescent patients were evaluated at three different periods: pre-treatment (T1), post-treatment (T2) and three years post-treatment (T3). Group 1 included 12 patients (with a mean age of 14.65 year) treated with Damon 3MX bracket system; and Group 2 included 15 patients (with a mean age of 14.8 year) who underwent orthodontic treatment with Roth prescribed brackets after expansion with Quad-Helix appliance. Relapse was evaluated with dental cast examination and cephalometric radiograph tracings. Statistical analysis was performed with IBM-SPSS for Windows software, version 21 (SPSS Inc., Chicago, IL). A p-value smaller than 0.05 was considered statistically significant. Results: There were significant increases in all transverse dental and postero-anterior measurements (except for UL6-ML mm in Group 1) with active treatment. There was some significant relapse in the long-term in inter-canine width in both groups and in the inter-first premolar width in Group 2 (p< 0.05). Significant decrease in all frontal measurements from T2 to T3 was seen for both groups. Upper and lower incisors significantly proclined in T1-T2 (p<0.05), however no relapse was found for both groups. When two systems were compared, there was no significant difference for the long-term follow-up period. Conclusion: Conventional (quad-helix appliance with conventional brackets) and Damon systems were found similar with regard to the long-term incisor positions and transverse dimension changes of maxillary arch.


2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 35-36
Author(s):  
Victor L Ishengoma ◽  
Raghavendra G Amachawadi ◽  
Kellen A Habib ◽  
Xiaorong Shi ◽  
Taghreed Mahmood ◽  
...  

Abstract Campylobacter and Salmonella are common food borne pathogens in the gut of pigs and are shed in the feces. The control of these bacteria in pigs is of importance in reducing the potential for transmission to humans. In swine, oral route, either in-feed or in-water, is by far the most common route of administration of antibiotics. Because the distribution of the antibiotic in the gut and the dosage are different, the impact of in-feed vs. in-water administration of antibiotics on the fecal shedding of food borne pathogens, Campylobacter and Salmonella, and on the development of antimicrobial resistance (AMR) in gut bacteria is a largely unexplored area. Therefore, a study was conducted to compare the effects of in-feed and in-water antibiotic administration on fecal prevalence of Campylobacter and Salmonella and AMR development in nursery piglets. A total of 1,296 weaned piglets were allocated into pens (48 pens; 27 pigs per pen) distributed in a single room. Pens were assigned randomly to six treatment groups; Control (No antibiotic), In-feed chlortetracycline (CTC), In-water CTC, In-feed tiamulin, In-water tiamulin, and a combination of CTC and tiamulin (In-feed). Fresh fecal samples were collected randomly from 5 of 27 piglets from each pen on pre-treatment (days -7, 0), treatment (days 7, 14) and post-treatment (days 21, 28) phases. Bacterial isolations and identifications were done by culture method and PCR, respectively. Overall prevalence of Campylobacter and Salmonella were 18.2% (262/1,440) and 3.9% (56/1,440) respectively. Speciation of Campylobacter isolates indicated C. hyointestinalis (17.9%; 258/1,440) and C. coli (0.3%; 4/1,440). Pigs from control group had a higher prevalence (P&lt; 0.05) of both Campylobacter and Salmonella when compared to other treatment groups. Both treatment and post-treatment phases had a significant effect on the prevalence of Campylobacter and Salmonella (P&lt; 0.05).


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