scholarly journals Comparison of different antibiotic treatment in children with community acquired pneumonia: a comparative study

2018 ◽  
Vol 5 (6) ◽  
pp. 2083
Author(s):  
Nasima Banu ◽  
Vijay Kumar Sukhani
Keyword(s):  
Emergency Department ◽  
Comparative Study ◽  
Antibiotic Treatment ◽  
Antimicrobial Agents ◽  
Study Groups ◽  
Community Acquired Pneumonia ◽  
First Line ◽  
Group 2 ◽  
Considerable Concern ◽  
Group 1

Background: community acquired pneumonia also known as CAP refers to pneumonia contracted by a person with little contact with the healthcare system. Narrow spectrum antibiotics are generally considered to be the first line of treatment however there is considerable concern about the emerging resistance among the usual CAP pathogens to the most commonly used antimicrobial agents. The objective of this study was comparison of different antibiotic treatment in children with community-acquired pneumonia.Method: A total of 100 paediatric patients who were admitted to the Emergency Department of medical institution with suspicion of pneumonia were included in the study. All the patients will be divided broadly into two study groups with 50 patients in each group. Group 1 patients were given intravenous amoxiclav, while Group 2 received intravenous ceftriaxone.Results: In present study subjects from, Group 1 i.e. amoxclav group 42% had fever, i.e. 24% were suffering from tachypnea and only 4% suffered from tachycardia and abnormal was found in 20/50 patients. Whereas in Group 2 -60% were suffering from fever, 16/50 i.e. 32% has tacypnea, 3/50 i.e. 6% had tachycardia and 16/50 i.e. 32 had abnormal WBC. In present study abnormal WBC was found to be more in first group.Conclusions: Ceftriaxone and amoxiclav can be used successfully in treatment of CAP.

scholarly journals Pharmacoeconomic analysis of the choice of antimicrobial drugs for the treatment of community-acquired pneumonia by physicians and final year medical students

2021 ◽  
Vol 20 (1) ◽  
pp. 16-23
Author(s):  
V. G. Deriushkin ◽  
S. V. Gatsura
Keyword(s):  
Antimicrobial Agents ◽  
Pharmacoeconomic Analysis ◽  
Outpatient Setting ◽  
Community Acquired Pneumonia ◽  
Medical Faculty ◽  
Ease Of Use ◽  
Patient Treatment ◽  
Preliminary Training ◽  
Group 2 ◽  
Group 1

The authors of the article conduct a pharmacoeconomic analysis of antimicrobial agents (AMA) prescriptions based on a survey of graduates of the medical faculty of a medical university and outpatient healthcare practitioners in Moscow. In addition to the pharmacoepidemiological part, the article also contains a pharmacoeconomic aspect to obtain a more complete picture, reflecting the choice of drugs not only in primary healthcare, but also among graduates of the medical faculty, who can potentially become its members without preliminary training in medical residency.The purpose of this study is to conduct a comparative pharmacoeconomic analysis of the AMA choice in the treatment of community-acquired pneumonia based on the data of a survey of general practitioners, district physicians and graduates of the medical faculty.Methodology. The 206 physicians took part in the anonymous voluntary survey.Results. 177 (85.9 %) of surveyed doctors were women and 62 (14.1 %) were men who made up Group 1. The average age of the surveyed doctors was 47.8±13.3 years, the average medical experience was 21.4±13.4 years. Group 2 consisted of 240 students, of which 178 were women (74.17 %) and 62 were men (25.83 %). The average age of the respondents in the group 2 was 24.8±3.3 years. When calculating the average cost of a treatment course of community-acquired pneumonia, depending on the structure of prescriptions, the value in Group 1 amounted to 420.82 rubles and 367.44 rubles in Group 2, while the share of costs for aminopenicillin drugs directly recommended for prescription to treat community-acquired pneumonia amounted to 8.35 and 4.97 %, respectively. Despite the current recommendations, respondents prefer to choose second-line AMAs, which are more expensive drugs. Respondents in both groups underestimate the first-line drugs that meet the current recommendations, namely aminopenicillins. Despite their low cost and ease of use in an outpatient setting, the frequency of their prescription remains low. The authors believe that more attention should be paid to the problem of rational use of antimicrobial agents. This problem can be solved through educational interventions at all levels of education, which can change the picture of drugs prescriptions in future, will allow practitioners and graduates of medical faculties to refer more often to clinical guidelines and patient treatment protocols. Comprehensive measures in this direction can not only positively affect the quality of medical care, but also reduce antibiotic resistance in the outpatient setting.

Immediate and long-term results of the first line chemotherapy in patients with metastatic triple negative breast cancer. Final analysis of randomized study

2020 ◽  
pp. 75-80
Author(s):  
S.A. Lyalkin ◽  
◽  
L.A. Syvak ◽  
N.O. Verevkina ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Randomized Study ◽  
Progression Free Survival ◽  
First Line ◽  
Free Survival ◽  
Group 2 ◽  
Line Chemotherapy ◽  
Group 1

The objective: was to evaluate the efficacy of the first line chemotherapy in patients with metastatic triple negative breast cancer (TNBC). Materials and methods. Open randomized study was performed including 122 patients with metastatic TNBC. The efficacy and safety of the first line chemotherapy of regimens АТ (n=59) – group 1, patients received doxorubicine 60 мг/м2 and paclitaxel 175 мг/м2 and ТР (n=63) – group 2, patients received paclitaxel 175 мг/м2 and carboplatin AUC 5 were evaluated. Results. The median duration of response was 9.5 months (4.5–13.25 months) in patients received AT regimen and 8.5 months (4.7–12.25 months), in TP regimen; no statistically significant differences were observed, р=0.836. The median progression free survival was 7 months (95% CI 5–26 months) in group 1 and 7.5 months (95% CI 6–35 months) in group 2, p=0.85. Both chemotherapy regimens (AT and TP) had mild or moderate toxicity profiles (grade 1 or 2 in most patients). No significant difference in gastrointestinal toxicity was observed. The incidence of grade 3–4 neutropenia was higher in patients of group 2 (TP regimen): 42.8% versus 27% (р<0.05). Conclusions. Both regimens of chemotherapy (AT and TP) are appropriate to use in the first line setting in patients with metastatic TNBC. Key words: metastatic triple negative breast cancer, chemotherapy, progression free survival, chemotherapy toxicity.

scholarly journals Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Daniele Tognetto ◽  
Chiara De Giacinto ◽  
Alberto Armando Perrotta ◽  
Tommaso Candian ◽  
Alessandro Bova ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Femtosecond Laser ◽  
Comparative Study ◽  
Surface Irregularity ◽  
Significant Difference ◽  
Group 2 ◽  
Cut Surface ◽  
Scanning Electron ◽  
Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

scholarly journals The negative effects of COVID-19 and national lockdown on emergency surgery morbidity due to delayed access

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Francesco A. Ciarleglio ◽  
Marta Rigoni ◽  
Liliana Mereu ◽  
Cai Tommaso ◽  
Alessandro Carrara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Transfusion ◽  
Emergency Surgery ◽  
Surgical Care ◽  
Close Correlation ◽  
Negative Effects ◽  
Group 2 ◽  
Retrospective Comparative Study ◽  
The Impact ◽  
Group 1

Abstract Background The aim of this retrospective comparative study was to assess the impact of COVID-19 and delayed emergency department access on emergency surgery outcomes, by comparing the main clinical outcomes in the period March–May 2019 (group 1) with the same period during the national COVID-19 lockdown in Italy (March–May 2020, group 2). Methods A comparison (groups 1 versus 2) and subgroup analysis were performed between patients’ demographic, medical history, surgical, clinical and management characteristics. Results Two-hundred forty-six patients were included, 137 in group 1 and 109 in group 2 (p = 0.03). No significant differences were observed in the peri-operative characteristics of the two groups. A declared delay in access to hospital and preoperative SARS-CoV-2 infection rates were 15.5% and 5.8%, respectively in group 2. The overall morbidity (OR = 2.22, 95% CI 1.08–4.55, p = 0.03) and 30-day mortality (OR = 1.34, 95% CI 0.33–5.50, =0.68) were significantly higher in group 2. The delayed access cohort showed a close correlation with increased morbidity (OR = 3.19, 95% CI 0.89–11.44, p = 0.07), blood transfusion (OR = 5.13, 95% CI 1.05–25.15, p = 0.04) and 30-day mortality risk (OR = 8.00, 95% CI 1.01–63.23, p = 0.05). SARS-CoV-2-positive patients had higher risk of blood transfusion (20% vs 7.8%, p = 0.37) and ICU admissions (20% vs 2.6%, p = 0.17) and a longer median LOS (9 days vs 4 days, p = 0.11). Conclusions This article provides enhanced understanding of the effects of the COVID-19 pandemic on patient access to emergency surgical care. Our findings suggest that COVID-19 changed the quality of surgical care with poorer prognosis and higher morbidity rates. Delayed emergency department access and a “filter effect” induced by a fear of COVID-19 infection in the population resulted in only the most severe cases reaching the emergency department in time.

scholarly journals Evaluation of Gingival Microleakage in Class II Composite Restorations with Different Lining Techniques: An In Vitro Study

Scientifica ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Vedavathi Bore Gowda ◽  
B. V. Sreenivasa Murthy ◽  
Swaroop Hegde ◽  
Swapna Devarasanahalli Venkataramanaswamy ◽  
Veena Suresh Pai ◽  
...  
Keyword(s):  
Study Groups ◽  
Class Ii ◽  
Composite Liner ◽  
Flowable Composite ◽  
Composite Restorations ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the microleakage in class II composite restorations without a liner/with resin modified glass ionomer and flowable composite liner.Method. Forty standardized MO cavities were prepared on human permanent mandibular molars extracted for periodontal reasons and then divided into 4 groups of ten specimens. The cavity preparations were etched, rinsed, blot dried, and light cured and Adper Single Bond 2 is applied. Group 1 is restored with Filtek P60 packable composite in 2 mm oblique increments. Group 2 is precure group where 1 mm Filtek Z350 flowable liner is applied and light cured for 20 sec. Group 3 is the same as Group 2, but the liner was cocured with packable composite. In Group 4, 1 mm RMGIC, Fuji Lining LC is applied and cured for 20 sec. All the teeth were restored as in Group 1. The specimens were coated with nail varnish leaving 1 mm around the restoration, subjected to thermocycling, basic fuchsin dye penetration, sectioned mesiodistally, and observed under a stereomicroscope.Results. The mean leakage scores of the individual study groups were Group 1 (33.40), Group 2 (7.85), Group 3 (16.40), and Group 4 (24.35). Group 1 without a liner showed maximum leakage. Flowable composite liner precured was the best.

scholarly journals Efficacy of azoximer bromide in the treatment of hospitalized patients with moderate to severe community-acquired pneumonia

2021 ◽  
pp. 106-117
Author(s):  
S. K. Zyryanov ◽  
O. I. Butranova ◽  
A. V. Ershov ◽  
Z. Sh. Manasova
Keyword(s):  
Combination Therapy ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Study Group ◽  
Therapy Regimen ◽  
Duration Of Hospital Stay ◽  
Comparator Group ◽  
Group 2 ◽  
Severe Community Acquired Pneumonia ◽  
Group 1

Introduction. The high incidence of community-acquired pneumonia and the high complication rates in the cases of severe pneumonia actualize the search for new pharmacotherapy tools to improve the effectiveness of standard patient management regimens. A high level of severe inflammatory response underlies the high risk for developing septic complications of pneumonia, along with impaired immune responses.The aim is to evaluate the efficacy of azoximer bromide introduction in the combination therapy regimen for hospitalized patients with moderate to severe community-acquired pneumonia.Materials and methods. A prospective, open label, parallel group, randomized study comparing the efficacy of azoximer bromide introduction in the combination therapy of hospitalized patients with moderate to severe community-acquired pneumonia was conducted at the premises of Federal Scientific and Clinical Center for Reanimatology and Rehabilitation. 30 patients were included in the study group and 37 patients in the comparator group. The baseline characteristics were comparable in both groups. Results. The azoximer bromide introduction in the combination therapy of patients with community-acquired pneumonia led to a statistically significant reduction in the duration of hospital stay (Me (LQ; HQ): 9 (8; 10) days for the study group and 13 (10; 14) days for the comparator group, (p = 0.000078), duration of ICU stay (Me (LQ; HQ) 2 days (1.5; 2.5) and 5 days (5.0; 6.0), respectively, (p = 0.00001), the duration of febrile fever 5 (± 0.6) days versus 10 (± 1.2) days (p = 0.0000), the incidence of acute respiratory failure (13.33% in group 1 versus 37.84% in group 2, p = 0.024) and septic shock (10% in group 1 versus 32.43% in group 2, p = 0.0285).Conclusions. The azoximer bromide introduction in the standard therapy regimen for patients with community-acquired pneumonia allowed to reduce the duration of hospital stay, the duration of ICU stay, the length of febrile fever, the incidence of septic shock and respiratory failure. The possible mechanisms of action may include a reduction of the severe inflammatory reactions and an optimization of the patient's immune response to the infectious process.

scholarly journals Characterization of Enamel After the Use of Oral Hygiene Auxiliaries with Whiteners

2019 ◽  
pp. 227-236
Author(s):  
Norma Verónica Zavala-Alonso DDS, MSc, PhD ◽  
Jorge Humberto Ramírez-González DDS, MSc ◽  
Mariana Ramírez-Vergara DDS ◽  
José Gilberto Roque-Márquez DDS, MSc ◽  
Flores Daniel Silva-Herzog DDS, MSc, PhD
Keyword(s):  
Oral Hygiene ◽  
Dental Enamel ◽  
Hardness Test ◽  
Study Groups ◽  
Micro Hardness ◽  
Sem Images ◽  
Group 4 ◽  
Group 2 ◽  
Mouth Wash ◽  
Group 1

The purpose of this study was to evaluate the effect of the use of the combined auxiliaries of oral hygiene with whitening agents on the micro-hardness and micro-morphology of dental enamel. Materials and Methods. 40 human incisors were used and sectioned to obtain 4x4mm samples and divided into four study groups. Group 1: Electric brushing with Toothpaste (BTP); Group 2: Electric brushing with Toothpaste+mouthwash (BTP+MW); Group 3: Electric brushing with Toothpaste+whitening pen (BTP+WP); Group 4: Electric brushing with Toothpaste+mouth wash+whitening pen (BTP+MW+WP). Samples were submitted toVickers micro-hardness test and visualized using scanning electron microscopy (SEM). Results. All groups, with the exception of group 1, showed a decrease in micro-hardness values after applying the treatments (p<0.05). Likewise, when comparing the values after the treatments between the groups, significant statistical differences were found in all of comparisons except for those of groups 2 and 4. SEM images showed changes in the morphology in all the study groups with the exception of group 1. Conclusion. Significant changes such as decrease in micro-hardness as well as in the topography of the enamel surface such as elevations, craters, porosities and etching patterns were founded after the use of the combination of auxiliaries of oral hygiene with whitening agents.  

scholarly journals Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

2021 ◽  
Vol 17 (16) ◽  
pp. 26-30
Author(s):  
Yu.A. Kucheryavy ◽  
◽  
P.R. Movtaeva ◽  
D.N. Andreev ◽  
R.I. Shaburov ◽  
...  
Keyword(s):  
Comparative Study ◽  
Underlying Disease ◽  
On Demand ◽  
Long Time ◽  
Prospective Comparative Study ◽  
Group 2 ◽  
Significant Regression ◽  
Risk Of Relapse ◽  
Group 1

Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

A COMPARATIVE STUDY TO EVALUATE THE OUTCOME OF PONSETI'S TECHNIQUE AND ACCELERATED PONSETI'S TECHNIQUE FOR CORRECTION OF CLUBFOOT

2021 ◽  
pp. 59-61
Author(s):  
Ashok Vidhyarthi ◽  
H.S. Varma ◽  
Rajeev Singh ◽  
Rajendra Thakur ◽  
Darwin Kumar Thakur
Keyword(s):  
Comparative Study ◽  
Ponseti Method ◽  
Congenital Deformity ◽  
Duration Of Treatment ◽  
Protocol Group ◽  
Pirani Score ◽  
Prospective Comparative Study ◽  
Group 2 ◽  
Accelerated Ponseti ◽  
Group 1

Introduction: Clubfoot is a common congenital deformity with incidence of1-6.8/1000 live births. Ponseti method is currently the gold standard for treatment of clubfoot which conventionally involves weekly plaster changes. A prospective comparative study was carried out at our hospital where we compared one group with weekly plaster change to other group with twice weekly plaster change, using the classical Ponseti protocol of manipulation. A total 50 feet (36 children ), divided into two Methods: groups, were randomly allocated to either Group 1 – 25 feet(accelerated Ponseti) or Group 2 – 25 feet (standard Ponseti). Group 2 underwent serial manipulations and casting once a week and Group 1 received manipulations and castings twice a week. Pirani score was documented at the time of presentation, after each cast, and at the time of removalof nal cast to assess the success of treatment ( Pirani score ≤1). A tota Results: l 43 feet (29 patients) underwent the entire course of treatment, while 7 patients discontinued the treatment during the course of the study. 14 patients, i.e, 21 feet were treated with Accelerated Ponseti Protocol (APP),i.e Group -1, and 15 patients, i.e, 22 feet were treated with Standard Ponseti Protocol (SPP), i.e Group-2. Mean duration of treatment from the rst cast to tenotomy in the accelerated ponseti protocol group was 20.57 ± 4.5 days (ranging from 12 to 29 days), and in standard ponseti protocol group was 39.66 ± 6.9 days (ranging from 29 to 51 days). Conclusion: Both the methods proved to be equally efcacious for the management of clubfoot in our study. However, the accelerated method had an overall shorter treatment duration making it convenient for the parents. As the patient is under direct observation of surgeons, complications, in any, are detected early and easily. Overall, the accelerated technique is more practical, benecial, and equally efcacious as standard ponseti technique, providing a more rapid correction of the deformity.

scholarly journals Internal endoscopic drainage as first line or second line treatment in case of postsleeve gastrectomy fistulas

2018 ◽  
Vol 06 (06) ◽  
pp. E745-E750 ◽  
Author(s):  
J. Gonzalez ◽  
D. Lorenzo ◽  
T. Guilbaud ◽  
T. Bège ◽  
M. Barthet
Keyword(s):  
Demographic Data ◽  
Median Number ◽  
Endoscopic Management ◽  
Endoscopic Drainage ◽  
Efficacy Rate ◽  
Second Line ◽  
First Line ◽  
Tertiary Center ◽  
Group 2 ◽  
Group 1

Abstract Background and study aims Management of post-sleeve gastrectomy fistulas (PSGF) recently has evolved, resulting in prioritization of internal endoscopic drainage (IED). We report our experience with the technique in a tertiary center. Patients and methods This was a single-center, retrospective study of 44 patients whose PSGF was managed with IED, comparing two periods: after 2013 (Group 1; n = 22) when IED was used in first line and before 2013 (Group 2; n = 22) when IED was applied in second line. Demographic data, pre-endoscopic management, characteristics of fistulas, therapeutic modalities and outcomes were recorded and compared between the two groups. The primary endpoint was IED efficacy; the secondary endpoint was a comparison of outcomes depending on the timing of IED in the management strategy. Results The groups were matched in gender (16 female, 16 male), mean age (43 years old), severity of fistula, delay before treatment, and exposure to previous endoscopic or surgical treatments. The overall efficacy rate was 84 % (37/44): 86 % in Group 1 and 82 % in Group 2 (NS). There was one death and one patient who underwent surgery. The median time to healing was 226 ± 750 days (Group 1) vs. 305 ± 300 days (Group 2) (NS), with a median number of endoscopies of 3 ± 6 vs. 4.5 ± 2.4 (NS). There were no differences in number of nasocavity drains and double pigtail stents (DPS), but significantly more metallic stents, complications, and secondary strictures were seen in Group 2. Conclusion IED for management of PSGF is effective in more than 80 % of cases whenever it is used during the therapeutic strategy. This approach should be favored when possible.

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