The isolate was, however, susceptible to moxifloxacin. Because parenteral pipericillin and moxifloxacin were not available in our setting, antimicrobial treatment was changed to ampicillin and ...gentamicin on day 5, and the fever resolved by day 9. The bacterium in this patient was resistant to most antibiotics that are recommended as empirical antibiotic therapy for neonatal meningitis,4 which probably accounts for the poor outcomes in this and the previous case.2 Prompt, appropriate antibiotic therapy is the cornerstone of treatment of meningitis.4 Outbreaks due to Elizabethkingia spp could pose a serious health problem because of the lack of measures to prevent nosocomial infections in many African hospitals, high rates of resistance to antibiotics,1 and the shortage of effective parenteral antibiotics.
Trial & Guidelines Roumen, R.; Boelens, O.; Van Assen, T. ...
Hernia : the journal of hernias and abdominal wall surgery
19, Številka:
Suppl 1
Journal Article
Objective To evaluate the success and complication rates of a single center’s multidisciplinary approach to transvenous lead extraction. Setting One university hospital. Participants One hundred ...ninety-five patients scheduled for transvenous lead extraction. Interventions A multidisciplinary approach to transvenous lead extraction involving cardiac surgery, electrophysiology, perfusion, and cardiac anesthesiology. Measurements and Main Results A case series of 351 lead extractions performed in 195 patients over a 42-month period. Indications, success rates, and complication rates were tracked and retrospectively evaluated and reported. Indications for lead extraction included 53.3% because of lead malfunction, 36.9% because of infection, with the remaining 9.7% from other categories such as venous stenosis. The lead extraction rate was 99.7%, with complete removal in 97.7%. The overall major complication rate was 3.08%. After an initial 1-year period of performing lead extractions, the overall major complication rate reduced to 1.23%. Conclusions Transvenous lead extraction generally is a safe procedure, but not without complications. A multidisciplinary approach involving cardiac surgery, electrophysiology, and cardiac anesthesiology allows for successful management and the ability to rapidly manage major complications.
Objectives Patients with left-sided heart dysfunction and volume overload often have associated elevations in vasopressin from neuroendocrine activation. The authors investigated perioperative levels ...of vasopressin in patients with isolated right-sided heart dysfunction from chronic thromboembolic pulmonary hypertension. Design Prospective, observational study. Setting Single center, tertiary hospital. Participants Patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary thromboendarterectomy. Interventions Vasopressin levels were measured in 22 patients during the perioperative period. Measurements and Main Results Vasopressin was undetectable in 8/22 patients at baseline. As a group, vasopressin levels at baseline and after induction of anesthesia were 0.8 pg/mL (median; 0.5-1.5, interquartile range of 25% and 75%) and 0.7 pg/mL (median; 0.5-1.4, interquartile range of 25% and 75%), respectively. During cardiopulmonary bypass (CPB), vasopressin increased to 13.9 pg/mL (median; 6.7-19.9, interquartile range of 25% and 75%). Vasopressin remained elevated after deep hypothermic circulatory arrest (DHCA) at 10.5 pg/mL (median; 6.5-19.9 interquartile range of 25% and 75%) and after CPB at 19.9 pg/mL (median; 11.1-19.9 interquartile range of 25% and 75%). Conclusions Vasopressin levels in PTE patients are in the low-to-normal range at baseline and may be a clinically relevant issue in the hemodynamic management of PTE.
ABSTRACT
We
identified
adpA
as an
araC
-like regulatory gene
needed for colonial morphogenesis in
Streptomyces
coelicolor
and showed that its activity depended on a unique
TTA triplet corresponding ...to the leucyl-tRNA gene (
bldA
).
These findings partially explained the dependence of aerial mycelium
formation on a rare tRNA that is postulated to have developmental
control
functions.
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