scholarly journals Trimethoprim-sulfamethoxazole versus norfloxacin in the prophylaxis of spontaneous bacterial peritonitis in cirrhosis

2005 ◽  
Vol 42 (4) ◽  
pp. 256-262 ◽  
Author(s):  
Roberto Fiolic Alvarez ◽  
Angelo Alves de Mattos ◽  
Esther Buzaglo Dantas Corrêa ◽  
Helma Pinchemel Cotrim ◽  
Tereza Virginia S. B. Nascimento
Keyword(s):  
Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
Protein Concentration ◽  
Serum Bilirubin ◽  
Inclusion Criteria ◽  
Bacterial Peritonitis ◽  
Number Of Patients ◽  
The Mean ◽  
To Receive ◽  
Mean Time

BACKGROUND: The prognosis of patients with chronic liver disease and spontaneous bacterial peritonitis is poor, being of great importance its prevention. AIM: To compare the effectiveness of trimethoprim-sulfamethoxazole versus norfloxacin for prevention of spontaneous bacterial peritonitis in patients with cirrhosis and ascites. PATIENTS AND METHODS: Fifty seven patients with cirrhosis and ascites were evaluated between March 1999 and March 2001. All of them had a previous episode of spontaneous bacterial peritonitis or had ascitic fluid protein concentration <1 g/dL and/or serum bilirubin > 2.5 mg/dL. The patients were randomly assigned to receive either 800/160 mg/day of trimethoprim-sulfamethoxazole 5 days a week or 400 mg of norfloxacin daily. The mean time of observation was 163 days for the norfloxacin group and 182 days for the trimethoprim-sulfamethoxazole group. In the statistical analysis, differences were considered significant at the level of 0.05. RESULTS: According to the inclusion criteria, 32 patients (56%) were treated with norfloxacin and 25 (44%) with trimethoprim-sulfamethoxazole. Spontaneous bacterial peritonitis occurred in three patients receiving norfloxacin (9.4%) and in four patients receiving trimethoprim-sulfamethoxazole (16.0%). Extraperitoneal infections occurred in 10 patients receiving norfloxacin (31.3%) and in 6 patients receiving trimethoprim-sulfamethoxazole (24.0%). Death occurred in seven patients (21.9%) who received norfloxacin and in five (20.0%) who received trimethoprim-sulfamethoxazole. Side effects occurred only in the trimethoprim-sulfamethoxazole group. CONCLUSION: In spite of the reduced number of patients and time of observation, trimethoprim-sulfamethoxazole and norfloxacin were equally effective in spontaneous bacterial peritonitis prophylaxis, suggesting that trimethoprim-sulfamethoxazole is a valid alternative to norfloxacin.

scholarly journals The validity of Triggering Receptor Expressed on Myeloid Cells (TREM-1) in diagnosis of Spontaneous Bacterial Peritonitis in cirrhotic patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W Abdelmonsef ◽  
N A Abdelkader ◽  
G A Ismail ◽  
M M Elgaafary ◽  
Y A Abdelrazek
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
Statistical Significant Difference ◽  
Bacterial Peritonitis ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
The Mean

Abstract Background Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients with ascites. Without early antibiotic treatment, this complication is associated with a 30-50% mortality rate. Recently we have evaluated the validity and utility of ascitic fluid triggering receptors expressed on myeloid cells-1 (TREM-1) levels for the diagnosis of SBP. Patients and Methods This was a Prospective case control study conducted on 60 patients with chronic liver disease and ascites divided into two group, group 1 (control) 30 patients without SBP and group 2 (SBP) 30 patients, admitted to the Tropical Medicine Department with ascites due to chronic liver disease. All patients were subjected to full history taking and clinical examination full laboratory investigations including complete blood picture liver and renal profiles, C reactive protein, viral markers, abdominal ultrasound, UGI endoscopy and ascitic fluid sampling for biochemical testing, total and differential cell count, microbiological culture and TREM-1 level. Results There was high statistical significant difference between the two groups in the base level of TREM-1 in which the mean was 1280 pg/ml (1136.9) with level range between (580---4500pg/ml) in SBP versus mean 129.9 pg/ml (51.9) with level range between (60-250pg/ml) in the control group. Also there was a statistical significant difference in the level of TREM-1 before and after treatment in the SBP patients in which the mean of TREM-1 before treatment was 1280.6 pg/ml (1136.9) with level range between (580-4500pg/ml) versus mean 376.2 pg/ml (78.4) and level range between (260-560 pg/ml) after the treatment. Conclusion our data indicate that the measurement of ascitic fluid TREM-1 is rapid, easy and valid test in the diagnosis and follow up of chronic liver disease patients with SBP.

Albumin Utilization in Spontaneous Bacterial Peritonitis

2021 ◽  
pp. 089719002199700
Author(s):  
Alex M. Ebied ◽  
Thakul Rattanasuwan ◽  
Yiqing Chen ◽  
Adonice P. Khoury
Keyword(s):  
High Risk ◽  
Spontaneous Bacterial Peritonitis ◽  
Total Bilirubin ◽  
Kidney Injury ◽  
Inclusion Criteria ◽  
Dosing Regimen ◽  
Bacterial Peritonitis ◽  
Risk Patients ◽  
The Impact ◽  
Order Set

Background: Albumin has been shown to decrease the incidence of mortality and acute kidney injury (AKI) in patients with spontaneous bacterial peritonitis (SBP). Albumin administration in SBP is recommended within 6 hours of diagnosis and for reserved use in high-risk patients with the following baseline laboratory tests: serum creatinine >1 mg/dL, blood urea nitrogen >30 mg/dL or total bilirubin >4 mg/dL. Objective: We aimed to assess the impact of an albumin order set restricted to high-risk SBP. Methods: A retrospective cohort study was conducted between Jan 1, 2013 to Feb 28, 2018. The albumin order set was implemented on Sep 20, 2016. Patients were included if they were diagnosed with SBP and had an ascitic fluid polymorphonuclear count ≥ 250 cells/mm3. Results: Out of a total of 137 patients reviewed, 88 met the inclusion criteria. The incidence of AKI in the pre-order set and post-order set were 63.93% and 33.33% (p = 0.01), respectively. The incidence of mortality in the pre-order set and post-order set were 36.07% and 7.41% (p = 0.005), respectively. The percentage of patients administered albumin within 6 hours were 24.59% to 40.74% (p = 0.14) in the pre-order set and post-order set, respectively. The percentage of patients who received the recommended albumin dosing regimen ordered was 42.62% vs 96.30% (p < 0.001), in the pre-order set and post-order set, respectively. Conclusion: The albumin order set restricted to high-risk SBP patients significantly reduced the incidence of AKI and mortality, and improved the appropriateness of albumin regimen ordered.

scholarly journals Effects of implementing rotational thromboelastometry in cardiac surgery: A retrospective cohort study

2021 ◽  
pp. 175045892095066
Author(s):  
Minna Kallioinen ◽  
Mika Valtonen ◽  
Marko Peltoniemi ◽  
Ville-Veikko Hynninen ◽  
Tuukka Saarikoski ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prothrombin Complex Concentrate ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Rotational Thromboelastometry ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
The Mean ◽  
To Receive ◽  
Frozen Plasma

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.

scholarly journals Renal impairment after Spontaneous Bacterial Peritonitis (SBP) in cirrhotic population.

2019 ◽  
Vol 26 (12) ◽  
pp. 2235-2240
Author(s):  
Asif Javaid Wakani ◽  
Riaz Hussain Awan ◽  
Seema Nayab ◽  
Khadim Hussain Awan ◽  
Faqir Muhammad Awan
Keyword(s):  
Liver Cirrhosis ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Spontaneous Bacterial Peritonitis ◽  
National Hospital ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Serum Blood Urea Nitrogen ◽  
Patient’S Information ◽  
The Mean

Objectives: To evaluate the frequency of renal impairment after spontaneous bacterial peritonitis (SBP) in cirrhotic population. Study Design: The study was conducted as Descriptive Cross-Sectional. Setting: Liaquat National Hospital Karachi. Period: For six months (October 01, 2015 to March 31, 2016). Methodology: The subjects with liver cirrhosis spontaneous bacterial peritonitis (SBP) were evaluated for serum creatinine and serum blood urea nitrogen (BUN) for evaluation of renal impairment while the patient’s information was recorded on proforma and analyzed in SPSS-15.0. Results: The mean ±SD of age, BUN and serum creatinine for whole population was 50.69±10.69 years, 22.4197±11.64742 and 1.2207±0.92535. Renal impairment was detected in 40 (27.2%) individuals while it is normal in 107 (72.8%) subjects. Conclusion: The renal impairment after SBP in cirrhotic population is higher in present study.

scholarly journals Recovery after ECT: comparison of propofol, etomidate and thiopental

2008 ◽  
Vol 30 (2) ◽  
pp. 149-151 ◽  
Author(s):  
Moacyr A Rosa ◽  
Marina O Rosa ◽  
Iara M T Belegarde ◽  
Celso R Bueno ◽  
Felipe Fregni
Keyword(s):  
Electroconvulsive Therapy ◽  
Electric Charge ◽  
Seizure Threshold ◽  
Recovery Profile ◽  
Different Types ◽  
The Mean ◽  
Hypnotic Drugs ◽  
To Receive ◽  
Mean Time ◽  
Therapy Treatment

OBJECTIVES: To compare post anesthetic time for patient recovery after electroconvulsive therapy, as measured by the post anesthetic Recovery Score of Aldrete and Kroulik, using three different types of hypnotic drugs (propofol, etomidate and thiopental). METHOD: Thirty patients were randomized to receive one of the three drugs (n = 10 in each group), during a course of electroconvulsive therapy treatment. Patients and raters were blinded to which drug was received. Main treatment characteristics were recorded (as total electric charge received seizure threshold, number of treatments, and the mean time for recovery) along the whole treatment. RESULTS: Thiopental and propofol were associated with a significance increase in charge needed to induce a seizure (p < 0.0001) when compared to etomidate, as well as a significant decrease of time for recovery (p = 0.042). CONCLUSIONS: These findings suggest that, although there seems to be no difference in the clinical outcome across these three drugs, propofol offers the best recovery profile. However, it makes a higher mean electric charge necessary.

scholarly journals A Double-Blind Randomized Prospective Study Comparing Ondansetron with Droperidol in the Prevention of Emesis following Strabismus Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 438-443 ◽  
Author(s):  
A. Davis ◽  
S. Krige ◽  
D. Moyes
Keyword(s):  
Recovery Time ◽  
Strabismus Surgery ◽  
Double Blind Study ◽  
Double Blind ◽  
Oral Fluids ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
To Receive ◽  
Mean Time

A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 μg/kg (Group A), ondansetron 75 μg/kg (Group B), or droperidol 75 fig/kg (Group C). All patients received a standardized anaesthetic technique. All episodes of emesis, recovery time, and time to tolerating oral fluids were recorded. The incidence of emesis during 24 hours was Groups A and B 19.7%, and Group C 28.2%. The lower incidence of emesis recorded by the ondansetron groups compared with the droperidol group was not statistically significant. Ondansetron at 75 μg/kg was as effective as 150 μg/kg in reducing emesis when compared with droperidol. Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.

Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study)

2009 ◽  
Vol 15 (5) ◽  
pp. 555-562 ◽  
Author(s):  
N Fernández Liguori ◽  
D Klajn ◽  
L Acion ◽  
F Cáceres ◽  
A Calle ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Latin American ◽  
Birth Defects ◽  
Birth Outcome ◽  
Inclusion Criteria ◽  
Retrospective Design ◽  
The Mean ◽  
Epidemiological Characteristics ◽  
Mean Time ◽  
Pregnancy And Birth

Background The influence of pregnancy on Multiple Sclerosis (MS) has been extensively studied but such influence on Latin American women with MS has not been characterized. Our objective was to describe the course of pregnancy and birth outcome in Argentinean MS patients and the evolution of MS during pregnancy and after delivery. Method We used a retrospective design in eight MS centers in Argentina and administered a survey to women with definite MS (Mc Donald) with pregnancies during or after MS onset. We contacted 355 women of which 81 met inclusion criteria. We recorded 141 pregnancies. Results Involuntary abortion was observed in 16% of pregnancies (95% CI = 10–23). Thirty five women received immunomodulatory therapy (IMT) before 42 pregnancies. Twenty three (55%) out of 42 pregnancies were exposed to IMT. The mean time of IMT discontinuation before conception in 19 (45.2%) pregnancies without exposure, was 104 days (95% CI = 61.0–147.0). There were 103 deliveries: 79% full term. Birth defects were detected in 19% of pregnancies exposed to IMT (95% CI = 4–46) and in 2% of non-exposed (95% CI = 0.3–8.0). The mean relapse rate was: pre-pregnancy year: 0.22 (95% CI = 0.12–0.32); pregnancy: 0.31 in 1st (95% CI = 0.10–0.52), 0.19 (95% CI = 0.03–0.36) in 2nd, and 0.04 in 3rd trimester (95% CI = –0.04–0.12); 1st trimester post delivery: 0.82 (95% CI = 0.42–1.22). Conclusion We observed a higher rate of birth defects among infants exposed to immunomodulators in utero than those not exposed. The reduction in MS relapses during 2nd and 3rd trimester of pregnancy and its increase during postpartum is consistent with previous reports.

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