Ascaris is a genus of parasitic nematodes that can cause infections in humans and pigs. During 2010-2013, we identified 14 cases of ascariasis in persons who had contact with pigs in Maine, USA. ...Ascaris spp. are important zoonotic pathogens, and prevention measures are needed, including health education, farming practice improvements, and personal and food hygiene.
We aimed to compare infection rates for two 3-day antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy (TRUSgbp) and demonstrate local microbiological trends. In 2008, ...558 men and, in 2009, 625 men had TRUSgpb. Regimen 1 (2008) comprised 400 mg Ofloxacin immediately before biopsy and 200 mg 12-hourly for 3 days. Regimen 2 (2009) comprised Ofloxacin 200 mg 12-hourly for 3 days commencing 24 hours before biopsy. 20/558 (3.6%) men had febrile episodes with regimen 1 and 10/625 (1.6%) men with regimen 2 (P=0.03). E. coli was the most frequently isolated organism. Overall, 7/13 (54%) of positive urine cultures were quinolone resistant and (5/13) 40% were multidrug resistant. Overall, 5/9 (56%) patients with septicaemia were quinolone resistant. All patients were sensitive to Meropenem. There was 1 (0.2%) death with regimen 1. Commencing Ofloxacin 24 hours before TRUSgpb reduced the incidence of febrile episodes significantly. We observed the emergence of quinolone and multidrug-resistant E. coli. Meropenem should be considered for unresolving sepsis.
Trust me McEvoy, Elizabeth M
BMJ,
09/2007, Letnik:
335, Številka:
7619
Journal Article
Recenzirano
Odprti dostop
In recent months, much has been written about the UK government's efforts to undermine doctors, to reduce us from autonomous professionals to tick-box automatons. In July the erratic weather ...conditions caused flash floods in the village, and June was trapped in her home by rising water levels.
Methods are described for measuring changes in atmospheric O2 concentration with emphasis on gas handling procedures. Cryogenically dried air samples are collected in 5 L glass flasks at ambient ...pressure and analyzed against reference gases derived from high‐pressure aluminum tanks. Fractionation effects are minimized by avoiding pressure and flow variations throughout the gas‐handling system. The overall external reproducibility is approximately ±3.3 per meg, with systematic errors associated with collecting samples and with storing them for 1 year reduced to the level of 3 per meg or smaller, The demonstrated short‐term reproducibly of air delivered from high‐presure tanks is ±1.5 per meg, with the composition changing by at most 5 per meg by surface desorption reactions as the tank is depleted to below 3500 kPa. A 9‐year survey of a suite of six reference gases showed no systematic long‐term trends in relative O2 concentrations to the level of 5 per meg. Results are presented from samples collected at Cape Grim (41°S), Macquarie Island (54°S) and the South Pole Station (90°S). From measurements spanning 1991–1995 it is found that the O2 concentrations at the South Pole are on average 3.6±1.2 per meg higher than at Cape Grim. This result runs contrary to the expectation that the air at high southern latitudes should be depleted in O2 as a result of O2 uptake from the Southern Ocean and may require the existence of unknown O2 sources near Antarctica or unexpected atmospheric transport patterns.
Trust me McEvoy, Elizabeth M
BMJ. British medical journal (International ed.),
09/2007, Letnik:
335, Številka:
7619
Journal Article
Recenzirano
In recent months, much has been written about the UK government's efforts to undermine doctors, to reduce them from autonomous professionals to tick-box automatons. McEvoy assert that there are some ...things that it cannot eradicate, much as it would love to. She recalls about a person she has met who had experience ill health and loss but regained strength from the fact that she was a doctor.
We present seven years of atmospheric O2/N2 ratio and CO2 concentration data measured from flask samples collected at American Samoa. These data are unusual, exhibiting higher short‐term variability, ...and seasonal cycles not in phase with other sampling stations. The unique nature of atmospheric data from Samoa has been noted previously from measurements of CO2, methyl chloroform, and ozone. With our O2 data, we observe greater magnitude in the short‐term variability, but, in contrast, no clear seasonal pattern to this variability. This we attribute to significant regional sources and sinks existing for O2 in both hemispheres, and a dependence on both the latitudinal and altitudinal origins of air masses. We also hypothesize that some samples exhibit a component of “older” air, demonstrating recirculation of air within the tropics. Our findings could be used to help constrain atmospheric transport models which are not well characterized in tropical regions.
Background
With among the lowest urologist per population ratios in Europe, the demand for urology specialist review in Ireland far exceeds supply. Lower urinary tract symptoms (LUTS) account for a ...significant number of referrals. The traditional paradigm of every patient being reviewed in a consultant-led clinic is unsustainable. New models of care with nurse-led clinics represent an opportunity to optimise limited resources.
Methods
Existing long-waiting male LUTS referrals were triaged to a specialist nurse-led LUTS clinic. After urology CNS assessment, charts were reviewed by a consultant urologist and a plan formulated. Relevant data were prospectively collected and analysed.
Results
Fifty-eight new male patients with LUTS were seen over a 6-month period with an average waiting time of 15.8 months. Patients were assessed with uroflowmetry, IPSS and DRE. Mean age was 64, IPSS 14.5, Qmax 18.3 ml/s and PVR 89 ml. Thirty patients (52%) were discharged directly with lifestyle modification and medical therapy.
Twenty-eight patients (48%) required one or more further investigations and subsequent review; 11 had flexible cystoscopy, 4 had urodynamics, 5 had prostate MRI, and 2 patients were listed for surgery (TURP and circumcision). The remaining 10 patients were for review post trial of lifestyle modifications and/or medical treatment. After review/investigations, 4 more patients were discharged. A total of 32 patients (55%) were discharged or listed for surgery after initial assessment. This total increased to 62% after a second review/investigations.
Conclusion
Introduction of a CNS-led LUTS clinic has significantly reduced the number of patients requiring follow-up in general urology clinics, representing a quality improvement in service provision.
Introduction
Modification of antibiotic prophylaxis prior to transrectal ultrasound-guided prostate biopsy (TRUSPB) based on pre-procedure rectal culture results is effective for prevention of ...infection from fluoroquinolone (FQ)-resistant and extended-spectrum beta-lactamase (ESBL)
Escherichia coli
strains. This has several implications for service delivery and cost. Our aim was to audit sepsis rates after introduction of ESBL screening and to identify risk factors for FQ resistance in ESBL strains and factors for sepsis risk.
Methods
This was a prospective cohort study from 2013 to 2016. TRUSPB patients underwent pre-procedure rectal swabs. ESBL-positive patients received amikacin in addition to ciprofloxacin prophylaxis. Patients filled a formal risk assessment questionnaire prior to biopsy.
Results
Sepsis rate after introduction of targeted prophylaxis reduced from 3.1% (2009–2012) to 1.4% (2013–2016). Of 38 ESBL patients,
n
= 5 (13%) developed severe post-TRUSPB sepsis. Among the FQ-resistant ESBL producers, the sepsis rate was 24%. Predictive factor for FQ resistance in ESBL producers included—antibiotic use in the last 3 months (OR 15). The logistic regression analysis did not identify any significant factor for post-TRUSPB sepsis in ESBL-positive patients once they had received additional prophylaxis.
Conclusion
In the face of rising TRUSPB sepsis and higher sepsis rates with ESBL carriers despite additional prophylaxis, introduction of a targeted antibiotic prophylaxis prior to TRUSPB sepsis prostate biopsies based on rectal swabs or urine cultures may reduce sepsis rates or clinicians may find themselves leaning towards increasingly performing transperineal biopsies with lower sepsis rates supporting the ‘trexit’ initiative.
Methods are described for measuring changes in atmospheric O
2
concentration with emphasis on gas handling procedures. Cryogenically dried air samples are collected in 5 L glass flasks at ambient ...pressure and analyzed against reference gases derived from high‐pressure aluminum tanks. Fractionation effects are minimized by avoiding pressure and flow variations throughout the gas‐handling system. The overall external reproducibility is approximately ±3.3 per meg, with systematic errors associated with collecting samples and with storing them for 1 year reduced to the level of 3 per meg or smaller, The demonstrated short‐term reproducibly of air delivered from high‐presure tanks is ±1.5 per meg, with the composition changing by at most 5 per meg by surface desorption reactions as the tank is depleted to below 3500 kPa. A 9‐year survey of a suite of six reference gases showed no systematic long‐term trends in relative O
2
concentrations to the level of 5 per meg. Results are presented from samples collected at Cape Grim (41°S), Macquarie Island (54°S) and the South Pole Station (90°S). From measurements spanning 1991–1995 it is found that the O
2
concentrations at the South Pole are on average 3.6±1.2 per meg higher than at Cape Grim. This result runs contrary to the expectation that the air at high southern latitudes should be depleted in O
2
as a result of O
2
uptake from the Southern Ocean and may require the existence of unknown O
2
sources near Antarctica or unexpected atmospheric transport patterns.
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