141 results on '"Intravenous antibiotics"'
Search Results
2. Acute Pancreatitis: The Increasing Role of Medical Management of a Traditionally Surgically Managed Disease
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Kittane Vishnupriya and Arjun Chanmugam
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medicine.medical_specialty ,business.industry ,Psychological intervention ,Early feeding ,General Medicine ,Disease ,medicine.disease ,Pancreatitis ,Intravenous antibiotics ,Intervention (counseling) ,Acute Disease ,Drainage ,Humans ,Minimally Invasive Surgical Procedures ,Medicine ,Acute pancreatitis ,business ,Intensive care medicine ,Surgical interventions - Abstract
Management of acute pancreatitis and its complications has rapidly evolved in recent years. The earlier pillars of management that included prolonged bowel rest, empiric intravenous antibiotics, and early surgical intervention for complications such as pancreatic necrosis have become much less common. The latest evidence-based approaches to acute pancreatitis are taking almost a diametrically different path to previous management. The current strategy focuses on early feeding, judicious use of antibiotics, and delayed use of invasive interventions. Even in complex cases, when surgical interventions may be indicated, there is an expressed preference for minimally invasive techniques. We review the changes that have evolved rapidly over the past decade in this common clinical problem.
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- 2022
3. Sepsis and Total Joint Arthroplasty
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Jeffrey B. Stambough, Simon C. Mears, Barnes Cl, Benjamin M. Stronach, and Karan M Patel
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medicine.medical_specialty ,Prosthesis-Related Infections ,Joint arthroplasty ,business.industry ,Arthroplasty, Replacement, Hip ,medicine.medical_treatment ,Periprosthetic ,medicine.disease ,Prosthesis ,Intensive care unit ,law.invention ,Sepsis ,law ,Bacteremia ,Intravenous antibiotics ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Arthroplasty, Replacement, Knee ,Intensive care medicine ,business - Abstract
The number of annual total joint arthroplasties (TJA) is increasing. Periprosthetic joint infections (PJI) occur when there is infection involving the prosthesis and surrounding tissue, which has the potential to develop into sepsis if left untreated. Sepsis in patients who have undergone TJA is life threatening and requires urgent treatment. If sepsis is due to PJI, the focus should be on early intravenous antibiotics with aspiration as soon as possible to diagnose the infection. Patients who develop sepsis after surgery for PJI are particularly at high risk for mortality and need to be treated in the intensive care unit.
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- 2022
4. Prognostic accuracy of qSOFA at triage in patients with suspected infection in a Brazilian emergency department
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João Carlos Batista Santana, Lucas Oliveira J. e Silva, Luciano Diogo, Daniel Pedrollo, Mario Castro Alvarez Perez, Henrique Herpich, Ian Ward A. Maia, and Rafael Nicolaidis
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Male ,medicine.medical_specialty ,Organ Dysfunction Scores ,Infections ,Sensitivity and Specificity ,Primary outcome ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,In patient ,Hospital Mortality ,Aged ,Retrospective Studies ,Adult patients ,business.industry ,Retrospective cohort study ,General Medicine ,Emergency department ,Odds ratio ,Middle Aged ,Prognosis ,Triage ,Anti-Bacterial Agents ,Intravenous antibiotics ,Emergency Medicine ,Female ,Emergency Service, Hospital ,business ,Brazil - Abstract
Objective To evaluate the prognostic accuracy of qSOFA for predicting in-hospital mortality among patients with suspected infection presenting to the ED of a public tertiary hospital in Brazil. Methods We performed a retrospective cohort study of consecutive adult patients (age ≥ 18 years) with suspected infection who presented to an academic tertiary ED in Porto Alegre (Southern Brazil) during an 18-month period. The qSOFA was calculated by using information collected at triage and patients were followed throughout hospitalization for the primary outcome of in-hospital mortality. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratios with corresponding 95% CIs were calculated for the qSOFA and qSOFA65. Results A total of 7523 ED visits of patients with suspected infection in which an intravenous antibiotic was administered within 24 h were included, which resulted in 908 in-hospital deaths (12.1%). There were 690 (9.2%) patients whose triage qSOFA was ≥2 points. When such cutoff was used, the sensitivity for in-hospital death was 24.6% (95% CI 21.8 to 27.4%) and the specificity was 92.9% (95% CI 92.3% to 93.5%). The sensitivity increased to 67.4% (95% CI 64.2% to 70.3%) when a cutoff of ≥1 was tested, but the specificity decreased to 55.3% (95% CI 54.1% to 56.5%). Using a cutoff of ≥2, the qSOFA65 had a sensitivity of 51.0% (95% CI 47.7% to 54.3%) and a specificity of 75.7% (95% CI 74.6% to 76.7%). Conclusions The qSOFA score yielded very low sensitivity in predicting in-hospital mortality. Emergency physicians or ED triage nurses in low-to-middle income countries should not be using qSOFA or qSOFA65 as “rule-out” screening tools in the initial evaluation of patients with suspected infection.
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- 2021
5. Are Oral Antibiotics an Effective Alternative to Intravenous Antibiotics in Treatment of Osteomyelitis of the Jaw?
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Andrea B. Burke, Alison Beieler, Shireesha Dhanireddy, Rachel Lim, Claire B. Mills, and Jasjit K. Dillon
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Antibiotics ,Administration, Oral ,Logistic regression ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Statistical significance ,Internal medicine ,medicine ,Humans ,Predictor variable ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Osteomyelitis ,Retrospective cohort study ,030206 dentistry ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Intravenous antibiotics ,Administration, Intravenous ,Female ,Surgery ,Oral Surgery ,business - Abstract
Purpose To review treatment of osteomyelitis of the jaw (OMJ) and determine whether antibiotic route and/or length of administration impacts resolution of infection postsurgically. Methods The investigators designed a retrospective cohort study enrolling a sample of patients treated at Harborview Medical Center from January 1, 2009 to December 31, 2019. The primary predictor variable was antibiotic administration route: oral (PO) only, intravenous (IV) only, IV transitioned to PO (IV + PO), or none. The secondary predictor was duration of antibiotic therapy (≤6 weeks or >6 weeks). The primary outcome variable was resolution of infection at 2 months follow-up posttreatment completion. The secondary outcome variable was number of surgeries to resolution of infection. Descriptive, bivariate, and multiple linear regression statistics were computed, with statistical significance set at P Results Sixty-seven individuals met inclusion criteria (38 male), mean age 51 years (18 to 88). Forty-nine (73%) received PO antibiotics, 12 (18%) IV + PO, 3 (4%) IV, and 3 (4%) none. Both PO and IV antibiotics were associated with clinical resolution (P = .022, .005, respectively) compared with debridement alone. Antibiotic duration of ≤6 weeks compared with >6 weeks was not significant. Seventy-six percent (51 of 67) required only 1 surgery. In the multivariate logistic regression, PO was associated with clinical resolution (P = .025, OR = 5.05). Penicillin allergy (P = 0.049, OR = 0.223) and diabetes (P = .008, OR = 0.104) were adversely associated with outcome. Conclusions OMJ was successfully treated with oral antibiotics and surgery. Prescribing 6 weeks of IV antibiotics may be antiquated. Clinicians should consider oral penicillins as first line whenever possible. Further studies are recommended.
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- 2021
6. 8th European Conference on Infections in Leukaemia: 2020 guidelines for the use of antibiotics in paediatric patients with cancer or post-haematopoietic cell transplantation
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Jukka Kanerva, Fanny Lanternier, Monica A. Slavin, Elio Castagnola, Andreas H. Groll, Dina Averbuch, Alessio Mesini, Roland A. Ammann, Carolina Garcia-Vidal, Simone Cesaro, Malgorzata Mikulska, Nicole Ritz, Jan Styczyński, Dorothea Pana, Adilia Warris, Thomas Lehrnbecher, HUS Children and Adolescents, and Children's Hospital
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medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,3122 Cancers ,Antibiotics ,Placebo-controlled study ,CHILDREN ,Guidelines as Topic ,Hematopoietic stem cell transplantation ,PLACEBO-CONTROLLED TRIAL ,INTRAVENOUS ANTIBIOTICS ,Pediatrics ,ANTIBACTERIAL PROPHYLAXIS ,CIPROFLOXACIN PROPHYLAXIS ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,LACTAMASE-PRODUCING ENTEROBACTERIACEAE ,RISK FEBRILE NEUTROPENIA ,610 Medicine & health ,Adverse effect ,Leukemia ,business.industry ,Hematopoietic Stem Cell Transplantation ,Cancer ,Congresses as Topic ,medicine.disease ,Anti-Bacterial Agents ,3. Good health ,Discontinuation ,ONCOLOGY PATIENTS ,Mycoses ,Oncology ,030220 oncology & carcinogenesis ,OUTPATIENT MANAGEMENT ,BLOOD-STREAM INFECTIONS ,business ,Febrile neutropenia - Abstract
Paediatric patients with cancer and those undergoing haematopoietic cell transplantation are at high risk of bacterial infections. The 8th European Conference on Infections in Leukaemia (ECIL-8) convened a Paediatric Group to review the literature and to formulate recommendations for the use of antibiotics according to the European Society of Clinical Microbiology and Infectious Diseases grading system. The evaluation of antibacterial prophylaxis included mortality, bloodstream infection, febrile neutropenia, emergence of resistance, and adverse effects as endpoints. Initial antibacterial therapy and antibiotic de-escalation or discontinuation focused on patients with a clinically stable condition and without previous infection or colonisation by resistant bacteria, and on patients with a clinically unstable condition or with previous infection or colonisation by resistant bacteria. The final considerations and recommendations of the ECIL-8 Paediatric Group on antibacterial prophylaxis, initial therapy, and de-escalation strategies are summarised in this Policy Review.
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- 2021
7. Prescription quality of prolonged antibiotherapy in pediatrics. Impact of ASP program interventions
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Susana Melendo, Pere Soler-Palacín, Meritxell Barnés-Mayolas, Aurora Fernández-Polo, Ivette Castellnou Asens, and Natalia Mendoza-Palomar
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Psychological intervention ,Inappropriate Prescriptions ,Antimicrobial ,03 medical and health sciences ,0302 clinical medicine ,Intravenous antibiotics ,Emergency medicine ,Medicine ,Antimicrobial stewardship ,030212 general & internal medicine ,Medical prescription ,business - Abstract
Introduction The duration adequacy of antibiotic regimens is one of the key points of Antimicrobial Stewardship Programs (ASP) given the relationship between the risk of resistance and days of exposure to antimicrobials. Methods Monitoring activities of intravenous antibiotics longer than 7 days at Hospital Infantil Vall d’Hebron, Barcelona, by reviewing data over a 34-weeks period from weekly cross-sectional analysis, followed by recommendations to prescribers to adapt their use. Results A total of 81 patients with 146 prolonged intravenous antibiotic treatments (78.8% of prescriptions were adequate) were reviewed. A total of 190 revisions were performed. 31 interventions on inappropriate prescriptions were carried out (61.3% of adherence to recommendation). Nineteen treatments were optimized (14 suspended, 5 de-escalated) reducing their duration by 8.75%. Conclusions Active intervention of ASP group is an effective tool to improve antibiotic optimization, reducing unnecessarily prolonged treatments, mainly on these areas with a greater range of improvement.
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- 2021
8. Oral Antibiotics and Abscess Formation After Appendectomy for Perforated Appendicitis in Children
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Jason C. Fisher, Keith A. Kuenzler, Sandra Tomita, Jee-Hye Choi, Alex Gordon, and Howard B. Ginsburg
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Male ,medicine.medical_specialty ,Abdominal Abscess ,Adolescent ,medicine.drug_class ,Patient demographics ,Antibiotics ,Administration, Oral ,Patient Readmission ,Drug Administration Schedule ,Leukocyte Count ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Appendectomy ,Humans ,University medical ,Child ,Abscess ,Retrospective Studies ,Postoperative Care ,Perforated Appendicitis ,business.industry ,General surgery ,Appendicitis ,medicine.disease ,Patient Discharge ,Appendix ,Anti-Bacterial Agents ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,030220 oncology & carcinogenesis ,Intravenous antibiotics ,Administration, Intravenous ,Female ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
There is little consensus regarding the use of postoperative antibiotics in the management of perforated appendicitis in children. Patients are commonly discharged with oral antibiotics after a course of intravenous antibiotics; however, recent literature suggests that patients can be safely discharged without any oral antibiotics. To further evaluate this protocol, we conducted a multicenter retrospective preimplementation/postimplementation study comparing rates of abscess formation and rehospitalization between patients discharged with and without oral antibiotics.We reviewed the records of all pediatric patients who underwent appendectomies for perforated appendicitis at NYU Tisch Hospital, Bellevue Hospital, and Hackensack University Medical Center from January 2014 to June 2019. Data pertaining to patient demographics, hospital course, intraoperative appearance of the appendix, antibiotic treatment, abscess formation, and rehospitalization were collected.A total of 253 patients were included: 162 received oral antibiotics and 91 did not. The median length of antibiotic treatment (oral and intravenous) was 11 (10-14) d for patients on oral antibiotics and 5 (3-6) d for patients without oral antibiotics (P 0.01). The median leukocyte count at discharge was 9.5 (7.4-10.9) and 8.1 (6.8-10.4) for these groups, respectively (P = 0.02). Postoperative abscesses occurred in 22% of patients receiving oral antibiotics and 15% of patients on no antibiotics (P = 0.25). Rates of rehospitalization for these groups were 10% and 11%, respectively (P = 0.99).Children who have undergone appendectomy for perforated appendicitis can be safely discharged without oral antibiotics on meeting clinical discharge criteria and white blood cell count normalization.
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- 2020
9. The Management of Pediatric Open Forearm Fractures
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Gregory Elia, Travis Blood, and Christopher Got
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medicine.medical_specialty ,030230 surgery ,Fractures, Open ,03 medical and health sciences ,0302 clinical medicine ,Forearm ,medicine ,Humans ,Initial treatment ,Orthopedics and Sports Medicine ,Child ,Retrospective Studies ,030222 orthopedics ,Tetanus ,business.industry ,Standard treatment ,Forearm Injuries ,Emergency department ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Debridement ,Intravenous antibiotics ,Emergency medicine ,Surgery ,business - Abstract
Open pediatric forearm fractures are common injuries that present to emergency departments across the United States. A total of 32% to 80% of all open pediatric fractures involve the forearm. Standard treatment for these injuries includes prompt intravenous antibiotic administration, tetanus prophylaxis, and usually bedside irrigation as a temporizing measure. Gustilo and Anderson type 2 and 3 open pediatric forearm fractures are generally managed with formal irrigation and debridement and fracture stabilization in the operating room. Management of Gustilo and Anderson type 1 open pediatric forearm fractures is not standardized, and level I evidence is currently lacking. Based on the existing data available, early antibiotic administration, bedside irrigation, and fracture stabilization in the emergency department may be a safe and effective initial treatment for these injuries, conferring a low risk for subsequent infection.
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- 2020
10. Vancomycin-soaked wrapping of harvested hamstring tendons during anterior cruciate ligament reconstruction. A review of the ‘vancomycin wrap’
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James G. Jefferies, Joanna M.S. Aithie, and Simon J. Spencer
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medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Vancomycin ,medicine ,Humans ,Surgical Wound Infection ,Orthopedics and Sports Medicine ,Autografts ,Preparatory phase ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Hamstring Tendons ,technology, industry, and agriculture ,030229 sport sciences ,Infection rate ,Anti-Bacterial Agents ,Surgery ,Intravenous antibiotics ,business ,Hamstring ,medicine.drug - Abstract
The practice of 'vancomycin wrapping' of harvested hamstring autografts during Anterior Cruciate Ligament Reconstruction (ACLR) surgery has gathered recent interest. This practice involves the wrapping of harvested grafts in a vancomycin-soaked swab during the preparatory phase. Different techniques are observed, and a small number of studies have shown that pre-soaking hamstring ACLR grafts in this manner dramatically reduces the post-surgical infection rate compared with standard intravenous antibiotic prophylaxis alone. However, the literature surrounding this practice is surprisingly limited and thus the basis and rationale of the 'vancomycin wrap' has established itself largely without question. The exact popularity of this practice is difficult to establish but there has been increasing disclosure of its efficacy in reducing post-operative infection in ACLR since 2012. We provide a synopsis of the current literature surrounding vancomycin and its use in 'wraps' in ACLR to help apprise the surgeon of the nature of infection in ACLR, the rationale for vancomycin, whilst considering evidence to support alternatives and discussing potential ramifications for future practice.
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- 2019
11. Compassionate Use of Lumacaftor/Ivacaftor in Cystic Fibrosis: Spanish Experience
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Maribel Barrio, María Teresa Pastor-Sanz, Alejandro López-Neyra, Ofelia Fernández, Marina Blanco-Aparicio, Luis Máiz, Alexandre Palou-Rotger, Pedro Mondejar-Lopez, Carmen Luna-Paredes, Rosa María Girón-Moreno, Isabel Delgado-Pecellín, Francisco Javier Gómez-de-Terreros-Caro, Esther Quintana-Gallego, Marta Ruiz-de-Valbuena, María Cols-i-Roig, Layla Diab-Cáceres, Maribel González, and Marta García-Clemente
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Adult ,Compassionate Use Trials ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,Cystic Fibrosis ,Aminopyridines ,Literature based ,Quinolones ,Aminophenols ,Cystic fibrosis ,Ivacaftor ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Benzodioxoles ,030212 general & internal medicine ,Child ,Chloride Channel Agonists ,Adverse effect ,Retrospective Studies ,business.industry ,Lumacaftor ,Mean age ,General Medicine ,Middle Aged ,medicine.disease ,Drug Combinations ,030228 respiratory system ,chemistry ,Spain ,Intravenous antibiotics ,Female ,Observational study ,business ,medicine.drug - Abstract
Background The most common cystic fibrosis (CF)-causing mutation is deltaF508 (F508del), which is present in 28% of CF Spanish patients. While the literature based on real-life studies on CF patients homozygous F508del treated with lumacaftor/ivacaftor is limited, it demonstrates the need for better strategies to prevent related adverse events (AEs) as well as the development of newer drugs. Methods We conducted a multicenter, retrospective, observational study to describe the effects of lumacaftor/ivacaftor treatment in real-life in Spain. 20 CF patients were included, all aged 6 and upwards and presented with ppFEV1 Results The mean age was 26.65 (range of 10–45), while the mean ppFEV1 before the treatment was 32.4% and mean BMI was 19.9 kg/m2. We analysed the changes in ppFEV1 and BMI from baseline during the treatment with lumacaftor/ivacaftor, but no differences were found. However, a moderate association between days of intravenous antibiotic needed and the use of lumacaftor/ivacaftor (p = 0.001) was established. Indeed, under the lumacaftor/ivacaftor, patients required 5.8 days of intravenous antibiotic treatment compared to 14.9 days prior to study. Also, severe pulmonary exacerbations requiring hospitalisation were statistically fewer under lumacaftor/ivacaftor treatment (p = 0.003). Finally, 75% of the sample presented with AEs, which led 35% of the subjects to discontinue the treatment. Conclusions While treatment with lumacaftor/ivacaftor resulted in an improvement in the number of pulmonary severe exacerbations, no improvement in ppFEV1 or BMI was found.
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- 2018
12. Medical management of a cavum septi pellucidi et vergae abscess in an adult: Case report and review of the literature
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Nicholas J Erickson, Arsalaan Salehani, Lauren E. Rotman, Kristen O. Riley, James Mooney, and Borna E Tabibian
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Cavum vergae ,Pediatrics ,medicine.medical_specialty ,Cavum septum pellucidum ,RD1-811 ,Medical treatment ,business.industry ,Adult case ,Case description ,medicine.disease ,Cavum septi pellucidi ,Abscess ,Optimal management ,Intravenous antibiotics ,Syndrome of inappropriate antidiuretic hormone secretion ,medicine ,Surgery ,Neurology. Diseases of the nervous system ,Neurology (clinical) ,Empyema ,RC346-429 ,business - Abstract
Background Abscesses of the cavum septi pellucidi (CSP) or cavum septi pellucidi et vergae (CSPV) are exceedingly rare with only ten cases previously reported. As so few cases have been published, there is no consensus on optimal management strategies with some recommending operative drainage and some suggesting more conservative approaches. Case description In this study we present the first reported case of a 51-year-old male presenting with syndrome of inappropriate antidiuretic hormone secretion and abscess of the CSPV secondary to otomastoiditis, treated successfully with intravenous antibiotics. A comprehensive review of the literature on CSP and CSPV abscesses was conducted with a focus on management strategies. Conclusions We conclude, clinical condition permitting, that medical treatment should be the initial strategy selected for the management of CSP and CSPV abscesses.
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- 2022
13. Sweat metabolomics before and after intravenous antibiotics for pulmonary exacerbation in people with cystic fibrosis
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Frederick W. Woodley, Christopher J. Nemastil, Emrah Gecili, Benjamin T. Kopp, Don Hayes, Rhonda D. Szczesniak, and Chandra L. Shrestha
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Cystic Fibrosis ,business.industry ,medicine.drug_class ,Metabolite ,Antibiotics ,medicine.disease ,Cystic fibrosis ,Article ,Anti-Bacterial Agents ,Pulmonary function testing ,SWEAT ,chemistry.chemical_compound ,Metabolomics ,chemistry ,Internal medicine ,Intravenous antibiotics ,Humans ,Medicine ,Prospective Studies ,Sweat ,business ,Pulmonary exacerbation - Abstract
Background People with cystic fibrosis (PWCF) suffer from acute unpredictable reductions in pulmonary function associated with a pulmonary exacerbation (PEx) that may require hospitalization. PEx symptoms vary between PWCF without universal diagnostic criteria for diagnosis and response to treatment. Research question We characterized sweat metabolomes before and after intravenous (IV) antibiotics in PWCF hospitalized for PEx to determine feasibility and define biological alterations by IV antibiotics for PEx. Study design and methods PWCF with PEx requiring hospitalization for IV antibiotics were recruited from clinic. Sweat samples were collected using the Macroduct® Sweat Collection System at admission prior to initiation of IV antibiotics and after completion prior to discharge. Samples were analyzed for metabolite changes using ultra-high-performance liquid chromatography/tandem accurate mass spectrometry. Results Twenty-six of 29 hospitalized PWCF completed the entire study. A total of 326 compounds of known identity were detected in sweat samples. Of detected metabolites, 147 were significantly different between pre-initiation and post-completion of IV antibiotics for PEx (average treatment 14 days). Global sweat metabolomes changed from before and after IV antibiotic treatment. We discovered specific metabolite profiles predictive of PEx status as well as enriched biologic pathways associated with PEx. However, metabolomic changes were similar in PWCF who failed to return to baseline pulmonary function and those who did not. Interpretation Our findings demonstrate the feasibility of non-invasive sweat metabolomic profiling in PWCF and the potential for sweat metabolomics as a prospective diagnostic and research tool to further advance our understanding of PEx in PWCF.
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- 2022
14. TTC7A mutation must be considered in patients with repeated intestinal atresia associated with early inflammatory bowel disease: Two new case reports and a literature review
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G. de Saint Basile, Yves Bertrand, N. Peretti, J. Fayard, Alain Lachaux, C. Malcus, T. Louazon, Marie-Pierre Cordier, Pierre-Yves Mure, B. Rohmer, S. Collardeau, Rémi Dubois, and R. Duclaux
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0301 basic medicine ,Severe combined immunodeficiency ,medicine.medical_specialty ,business.industry ,Intestinal atresia ,medicine.disease ,Inflammatory bowel disease ,Gastroenterology ,03 medical and health sciences ,030104 developmental biology ,Parenteral nutrition ,Intravenous antibiotics ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Mutation (genetic algorithm) ,medicine ,In patient ,business ,Rare disease - Abstract
TTC7A mutations cause multiple neonatal intestinal atresias with early inflammatory bowel disease and severe combined immunodeficiency. There are no treatment protocols for this rare disease. Two new cases are described for which radical early treatment measures – total enterectomy, home parenteral nutrition, immunoglobulin therapy and intravenous antibiotic prophylaxis – have allowed both patients to develop optimally.
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- 2018
15. Pulmonary exacerbations and acute declines in lung function in patients with cystic fibrosis
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David J. Pasta, Stefanie J. Millar, Michael J. Williams, Michael W. Konstan, Jeffrey S. Wagener, and Wayne J. Morgan
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Epidemiologic study ,Adolescent ,Cystic Fibrosis ,medicine.drug_class ,Clinical Decision-Making ,Antibiotics ,Cystic fibrosis ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,Longitudinal Studies ,030212 general & internal medicine ,Child ,Lung ,Lung function ,business.industry ,Patient Acuity ,medicine.disease ,United States ,Anti-Bacterial Agents ,Respiratory Function Tests ,Early Diagnosis ,030228 respiratory system ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,Cohort ,Disease Progression ,Female ,business - Abstract
Background Patients with cystic fibrosis (CF) who experience acute declines in percent predicted FEV 1 (ppFEV 1 decreased ≥10% relative to baseline) are often not treated with antibiotics for pulmonary exacerbations (PEx), whereas other patients are treated even when they have not experienced a decline in lung function. Methods We analyzed 2 patient cohorts using 3 years of Epidemiologic Study of CF data. Cohort 1 (12,837 patients) experienced a ≥10% acute decline in ppFEV 1 (n = 22,898) and Cohort 2 (10,416 patients) had a clinician-diagnosed PEx (n = 20,731). Results 70.7% of ≥10% decline events were treated with antibiotics; with intravenous antibiotics used 67.1% of the time. 32.0% of clinician-diagnosed PEx declined Conclusions A clinician's decision to diagnose a PEx and treat with antibiotics often is not defined by measured lung function: a ≥10% FEV 1 decline is not considered an absolute indication of a PEx and the lack of a decline does not contraindicate a PEx. Clinicians appear to use the history of prior PEx plus other variables as factors for diagnosing PEx.
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- 2018
16. Should we bury K-wires after metacarpal and phalangeal fracture osteosynthesis?
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Thomas Bo Jensen, Mads Terndrup, Søren Kring, and Martin Lindberg-Larsen
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Treatment outcome ,030230 surgery ,Metacarpal bones ,Finger Phalanges ,Fracture Fixation, Internal ,Fractures, Bone ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Postoperative infection ,Humans ,Surgical Wound Infection ,Medicine ,Outpatient clinic ,Bone Wires ,Device Removal ,Aged ,Retrospective Studies ,General Environmental Science ,Aged, 80 and over ,030222 orthopedics ,Osteosynthesis ,business.industry ,Retrospective cohort study ,Metacarpal Bones ,Middle Aged ,Surgery ,Treatment Outcome ,Intravenous antibiotics ,General Earth and Planetary Sciences ,Female ,business - Abstract
Background Burying Kirschner wires (K-wires) under the skin after metacarpal and phalangeal fracture osteosynthesis may reduce risk of infection, but it might also complicate later removal. Purpose/aim of study To examine infection and reoperation rates after metacarpal and phalangeal fracture osteosynthesis with buried versus exposed K-wires. Materials and methods Metacarpal and phalangeal fractures treated with K-wire osteosynthesis at our institution from 1st of January, 2009 to 1st of February, 2015 were identified retrospectively. The final study population included 444 patients, 331 with metacarpal, 109 phalangeal and 4 with mixed fractures. Surgical and patient records were examined 90 days postoperatively. Findings/results 337 patients (75.9%) were treated with buried K-wires and 107 patients (24.1%) with exposed (non-buried) K-wires. 14 patients (4.1%) treated with buried K-wires presented with postoperative infection, opposed to 7 patients (6,5%) treated with non-buried K-wires (p = 0.311). None of the postoperative infections caused re-operation. Only one case of deep/severe infection was recorded in a patient treated with buried K-wires requiring intravenous antibiotic treatment. In 58 of 337 patients (17.2%) treated with buried K-wires, removal was not possible in the outpatient clinic and required readmission for removal in the operation theatre. All exposed K-wires could be removed in the out-patient clinic without re-operation. Conclusions We found no difference in postoperative infection rate between metacarpal and phalangeal fracture osteosynthesis with buried versus exposed K-wires. However, the high readmission and reoperation rate (17.2%) after burying K-wires should call for reconsideration of surgical strategies.
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- 2018
17. Do cystic fibrosis centres with the lowest FEV1 still use the least amount of intravenous antibiotics? A registry-based comparison of intravenous antibiotic use among adult CF centres in the UK
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Michael J. Campbell, Stephen J Walters, Rachael Curley, Zhe Hui Hoo, and Martin J Wildman
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Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Epidemiologic study ,business.industry ,Clinical epidemiology ,medicine.disease ,Cystic fibrosis ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,Registry data ,030212 general & internal medicine ,business ,Pulmonary exacerbation - Abstract
Background The Epidemiologic Study of Cystic Fibrosis using 1995–1996 and 2003–2005 data found that CF centres with lowest FEV 1 tended to use fewer intravenous antibiotics. We repeated the analyses using 2013–2014 UK CF registry data to determine if this was still the case. Methods Analysing data for 2013 and 2014 separately, 28 adult CF centres were ranked according to median % age-adjusted FEV 1 . The top 7 centres were placed in the ‘upper quarter' (best FEV 1 ), the bottom 7 centres in ‘lower quarter' (lowest FEV 1 ), and the rest in ‘middle half'. IV use was stratified according to %FEV 1 , then compared between the three groups. Results Centres in the ‘upper quarter' and ‘middle half' used significantly more IV antibiotics compared to centres in the ‘lower quarter' (van Elteren test P -value Conclusions CF centres with lowest FEV 1 are still distinguished by lower use of intravenous antibiotics.
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- 2018
18. Brain abscess of a very elderly patient likely caused by maxillary osteomyelitis from odontogenic infection: A case report
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Yasuhiro Nakai, Mao Tanaka, Minoru Miyake, Fumi Nakai, Yumiko Ohbayashi, Yuuri Houchi, Akinori Iwasaki, Ryo Miyazaki, and Takaaki Ogawa
- Subjects
Odontogenic infection ,medicine.medical_specialty ,business.industry ,Dental infections ,Osteomyelitis ,030206 dentistry ,medicine.disease ,Pathology and Forensic Medicine ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Intravenous antibiotics ,medicine ,Oral Surgery ,Complication ,Whole body ,Elderly patient ,business ,Brain abscess - Abstract
The typical origins of brain abscesses are cranial trauma or surgery, or infections secondary to a septic focus elsewhere, but also in rare cases, odontogenic contagion. In this report, we describe a case of a brain abscess subsequent to maxillary osteomyelitis from odontogenic infection. On examination for maxillary osteomyelitis of an 87-year-old woman, a brain abscess was discovered by chance. Surgery for osteomyelitis and intravenous antibiotics for over 2 months improved her symptoms and she was discharged. Over two years have passed since her discharge, and her whole body remains in good condition with no recurrence. Physicians should be aware of the potential complication of brain abscess when treating patients for dental infections.
- Published
- 2019
19. Management of parapharyngeal and retropharyngeal space infections
- Author
-
Jo-Lawrence Martinez Bigcas and Kunal S. Jain
- Subjects
medicine.medical_specialty ,business.industry ,Surgery ,03 medical and health sciences ,Broad spectrum ,0302 clinical medicine ,medicine.anatomical_structure ,Otorhinolaryngology ,Treatment plan ,Intravenous antibiotics ,medicine ,Parapharyngeal space ,030212 general & internal medicine ,Radiology ,030223 otorhinolaryngology ,Airway ,business ,Retropharyngeal space - Abstract
Deep neck space infection is a relatively common condition with potentially catastrophic, life-threatening complications. A detailed understanding of the topography of the neck, relationships between compartments of the neck, and the propagation of infection is essential for accurate assessment and formulation of a propitious and timely treatment plan. This article focuses on approaches to the deepest spaces in the anterior neck—the parapharyngeal space and retropharyngeal space (RPS). Treatment starts with assessment and assurance of a safe, stable airway, broad spectrum intravenous antibiotics, and contrasted imaging to formulate a surgical plan. The parapharyngeal space and retropharyngeal space may be approached transorally or transcervically. Sound surgical principles, namely wide incision and dependent drainage, may prevent the further spread and associated morbidity.
- Published
- 2017
20. A treatment evaluator tool to monitor the real-world effectiveness of inhaled aztreonam lysine in cystic fibrosis
- Author
-
Daniel Peckham, Cedric Gunaratnam, Charles S. Haworth, Diana Bilton, Barry J. Plant, R. Ian Ketchell, Damian G. Downey, Edward F. McKone, Andrew Jones, and Joseph A. Eustace
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Cystic Fibrosis ,Aztreonam ,Routine practice ,Cystic fibrosis ,Body Mass Index ,03 medical and health sciences ,chemistry.chemical_compound ,AZTREONAM LYSINE ,0302 clinical medicine ,Forced Expiratory Volume ,Internal medicine ,Administration, Inhalation ,Journal Article ,medicine ,Humans ,Pseudomonas Infections ,In patient ,Pediatrics, Perinatology, and Child Health ,030212 general & internal medicine ,Lung function ,business.industry ,Lysine ,Intravenous antibiotics ,Evaluation tool ,medicine.disease ,Anti-Bacterial Agents ,Respiratory Function Tests ,Surgery ,Hospitalization ,Treatment Outcome ,030228 respiratory system ,chemistry ,Pseudomonas aeruginosa ,Pediatrics, Perinatology and Child Health ,Female ,Drug Monitoring ,business ,Body mass index ,Forced expiratory volume - Abstract
Background: Studies are required that evaluate real-world outcomes of inhaled aztreonam lysine in patients with cystic fibrosis (CF). Methods: Our treatment-evaluator tool assessed the effectiveness of inhaled aztreonam in routine practice in 117 CF patients across four time periods (6-12 (P2) and 0-6months (P1) pre-initiation, and 0-6 (T1) and 6-12months (T2) post-initiation). Outcomes were: changes in %-predicted forced expiratory volume in 1s (FEV1), body-mass index (BMI), hospitalisation days and intravenous antibiotic usage. Results: Median FEV1% predicted for each 6-month period was 38.9%, 34.6%, 37.1% and 36.5%; median change was -2.0% between P2 and P1, increasing to +0.6% (p
- Published
- 2017
21. Fr527 ORAL VERSUS INTRAVENOUS ANTIBIOTIC REGIMENS IN THE MANAGEMENT OF INTRA-ABDOMINAL ABSCESSES IN PENETRATING CROHN'S DISEASE
- Author
-
Simon Hong, Shannon Chang, Kush M. Fansiwala, David Hudesman, Bari Dane, Feza H. Remzi, Jordan E. Axelrad, and Haluk Tarik Kani
- Subjects
Crohn's disease ,medicine.medical_specialty ,Hepatology ,business.industry ,Intravenous antibiotics ,Gastroenterology ,Medicine ,Intra-abdominal Abscess ,business ,medicine.disease ,Surgery - Published
- 2021
22. Corrigendum to 'A survey of critical care nurses’ practices and perceptions surrounding early intravenous antibiotic initiation during septic shock' [Intensive Crit. Care Nurs. 41 (2017) 90–97]
- Author
-
Abdullah M Alhammad, Erik Garpestad, Lindsay Crossley, Russel J. Roberts, Eric Anketell, LeeAnn Wood, John W. Devlin, and Greg Schumaker
- Subjects
medicine.medical_specialty ,Septic shock ,business.industry ,Intravenous antibiotics ,Critical care nursing ,medicine ,MEDLINE ,Critical Care Nursing ,medicine.disease ,Intensive care medicine ,business - Published
- 2021
23. Standardized Treatment of Pulmonary Exacerbations (STOP) study: Observations at the initiation of intravenous antibiotics for cystic fibrosis pulmonary exacerbations
- Author
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Cori L. Daines, Jonathan E. Spahr, Ronald L. Gibson, Patrick A. Flume, Donald R. VanDevanter, Don B. Sanders, Valeria V. Beckett, George M. Solomon, Christopher H. Goss, Sonya L. Heltshe, Natalie E. West, Jerry A. Nick, and Bruce C. Marshall
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,Clinical study design ,Antibiotics ,medicine.disease ,Cystic fibrosis ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Intravenous antibiotics ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Observational study ,030212 general & internal medicine ,Allergic bronchopulmonary aspergillosis ,Intensive care medicine ,business ,Prospective cohort study - Abstract
Background The Standardized Treatment of Pulmonary Exacerbations (STOP) program has the intent of defining best practices in the treatment of pulmonary exacerbations (PEx) in patients with cystic fibrosis (CF). The objective of this analysis was to describe the clinical presentations of patients admitted for intravenous (IV) antibiotics and enrolled in a prospective observational PEx study as well as to understand physician treatment goals at the start of the intervention. Methods We enrolled adolescents and adults admitted to the hospital for a PEx treated with IV antibiotics. We recorded patient and PEx characteristics at the time of enrollment. We surveyed treating physicians on treatment goals as well as their willingness to enroll patients in various study designs. Additional demographic and clinical data were obtained from the CF Foundation Patient Registry. Results Of 220 patients enrolled, 56% were female, 19% were adolescents, and 71% were infected with P. aeruginosa. The mean (SD) FEV1 at enrollment was 51.1 (21.6)% predicted. Most patients (85%) experienced symptoms for ≥ 7 days before admission, 43% had received IV antibiotics within the previous 6 months, and 48% received oral and/or inhaled antibiotics prior to IV antibiotic initiation. Forty percent had ≥ 10% FEV1 decrease from their best value recorded in the previous 6 months, but for 20% of patients, their enrollment FEV1 was their best FEV1 recorded within the previous 6 months. Physicians reported that their primary treatment objectives were lung function recovery (53%) and improvement of symptoms (47%) of PEx. Most physicians stated they would enroll patients in studies involving 10-day (72%) or 14-day (87%), but not 7-day (29%), treatment regimens. Conclusions Based on the results of this study, prospective studies are feasible and physician willingness for interventional studies of PEx exists. Results of this observational study will help design future PEx trials.
- Published
- 2017
24. Timing of Operative Debridement in Open Fractures
- Author
-
Samir Mehta, Keith P Connolly, and Joshua C. Rozell
- Subjects
030222 orthopedics ,medicine.medical_specialty ,business.industry ,Optimal treatment ,medicine.medical_treatment ,Operative Time ,Time optimal ,Surgery ,Fractures, Open ,03 medical and health sciences ,0302 clinical medicine ,Multiple factors ,Debridement ,Intravenous antibiotics ,Debridement (dental) ,Orthopedic surgery ,medicine ,Humans ,Surgical Wound Infection ,Infection control ,Initial treatment ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,business - Abstract
The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement.
- Published
- 2017
25. Catheter-related infections in patients with haematological malignancies: novel preventive and therapeutic strategies
- Author
-
Anne-Marie Chaftari, Ramia Zakhour, and Issam I Raad
- Subjects
0301 basic medicine ,Catheterization, Central Venous ,medicine.medical_specialty ,business.industry ,030106 microbiology ,Bacteremia ,medicine.disease_cause ,Catheter-Related Infections ,03 medical and health sciences ,Patient population ,Catheter ,Catheters, Indwelling ,Infectious Diseases ,Hematologic Neoplasms ,Intravenous antibiotics ,Bloodstream infection ,Anti-Infective Agents, Local ,Humans ,Medicine ,In patient ,business ,Intensive care medicine ,Anti-Infective Agents ,Staphylococcus - Abstract
Central venous catheters are essential for the treatment of patients with haematological malignancies and the recipients of stem-cell transplant. This patient population is, however, at high risk for catheter-related bloodstream infections that can result in substantial morbidity, mortality, and health-care-associated costs. Efficient prevention, early diagnosis, and effective treatment are essential to providing the best care to these patients. Although confirming the catheter as a source of infection remains challenging, the Infectious Diseases Society of America definition of catheter-related bloodstream infection remains the most precise definition to use in these patients. Gram-positive bacteria, particularly coagulase-negative Staphylococcus spp, remain the leading cause of catheter-related bloodstream infection, although an increase in Gram-negative bacteria as the causative agent has been noted. Although removal of the line and appropriate intravenous antibiotics remain the mainstay of treatment in most cases, novel technologies, including exchange with antibiotic-coated catheters and treatment with lock solutions, are particularly relevant in this patient population. In this Review we present the types of central venous catheters used in this patient population and analyse the different definitions of catheter-related infections, with an overview of their prevention and management.
- Published
- 2016
26. Spinal epidural abscesses: Diagnosis and current treatment options
- Author
-
Bradley Moatz, John M. Rhee, and Keith W. Michael
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,business.industry ,Treatment options ,Spinal epidural abscess ,Surgery ,03 medical and health sciences ,Surgical decompression ,0302 clinical medicine ,Spinal epidural ,Intravenous antibiotics ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Thecal sac ,business ,030217 neurology & neurosurgery - Abstract
Spinal epidural abscess is relatively infrequent diagnosis with life-threatening potential. Early diagnosis is imperative as neurological deficits negatively impact a patient’s prognosis. This process results from purulent material accumulating between the thecal sac and the osseous-ligamentous structures of the spine. Developments in imaging techniques have permitted earlier diagnosis of this condition. Emergent surgical decompression with intravenous antibiotics remains the cornerstone of treatment.
- Published
- 2016
27. Update on Selected Pediatric Hip Disorders
- Author
-
Mary A. Blaszko Helming
- Subjects
musculoskeletal diseases ,Advanced and Specialized Nursing ,medicine.medical_specialty ,Nurse practitioners ,business.industry ,Avascular necrosis ,Disease ,medicine.disease ,Surgery ,Femoral head ,medicine.anatomical_structure ,Synovitis ,Intravenous antibiotics ,medicine ,Legg-Calve-Perthes disease ,Septic arthritis ,business - Abstract
Several pediatric hip disorders are essential for the nurse practitioner to recognize, manage, and refer. In this study, the following selected hip disorders are described: developmental dysplasia of the hips; Legg-Calve-Perthes disease; transient synovitis of the hip; and septic arthritis of the hip. Developmental dysplasia of the hips can occur congenitally or in early childhood. Legg-Calve-Perthes disease is an avascular necrosis of the femoral head that occurs between 4 and 8 years of age. Transient synovitis of the hip is benign and self-limited, but its danger is that it can mimic septic arthritis of the hip. Septic arthritis of the hip is a medical emergency that requires operative intervention and intravenous antibiotics.
- Published
- 2015
28. P297 Change in 6-minute exercise test in children with cystic fibrosis admitted for intravenous antibiotics and physiotherapy
- Author
-
L. Lowndes, C. Hamilton, K. Lock, and D. McShane
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Intravenous antibiotics ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Medicine ,business ,medicine.disease ,Cystic fibrosis ,Test (assessment) - Published
- 2020
29. Retropharyngeal abscess and mediastinitis as an uncommon complication of varicella infection
- Author
-
José Luis Llorente, Sergio Menéndez, Daniel Pedregal-Mallo, Patricia García-Cabo, Marta Menéndez del Castro, Ana Vivanco-Allende, Andrés Coca-Pelaz, and Laura Fernández-Vañes
- Subjects
medicine.medical_specialty ,Chickenpox ,business.industry ,Retropharyngeal abscess ,Context (language use) ,General Medicine ,medicine.disease ,Mediastinitis ,Surgery ,Mediastinal abscess ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,030225 pediatrics ,Intravenous antibiotics ,Varicella infection ,Pediatrics, Perinatology and Child Health ,medicine ,030223 otorhinolaryngology ,business ,Complication - Abstract
Varicella infection is one of the most common and contagious infection in children and could course with severe complications. We report the case of a 4-year-old patient derived to our hospital for suspicion of suppurative complication in the context of a varicella infection. A computerized tomographic scanning was performed, showing a large retropharyngeal abscess with mediastinitis. Complications of varicella are up to 2% of patients, but this is the first report of a retropharyngeal and mediastinal abscess in this context. In the face of clinical suspicion, early intervention is important through imaging, intravenous antibiotics and surgical drainage in necessary cases.
- Published
- 2020
30. How Does Double Tunnel Driveline Derivation Technique Contributes to Treatment of Driveline Infection?
- Author
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Satsuki Fukushima, Tomoyuki Fujita, T. Taguchi, N. Tadokoro, Junjiro Kobayashi, and Y. Shimahara
- Subjects
Pulmonary and Respiratory Medicine ,Transplantation ,medicine.medical_specialty ,business.industry ,Surgery ,medicine.anatomical_structure ,Intravenous antibiotics ,medicine ,Abdomen ,Derivation method ,Major complication ,Derivation ,Cardiology and Cardiovascular Medicine ,Surgical treatment ,Upper abdomen ,business ,Subcutaneous tissue - Abstract
Purpose Driveline infection (DLI) is one of the major complications after durable VAD implantation. Since 2016, we have changed from the standard method to a double-tunnel method for driveline (DL) derivation, in which DL was once led to the upper right abdomen, then passed through the subcutaneous tissue horizontally to the left upper abdomen. This study aimed to verify the therapeutic efficacy of the double tunnel method on DLI. Methods From April 2013 to January 2019, all 120 cases of HeartMate2(HM2) implanted for BTT at our hospital were divided into 2 groups; 38 cases for whom DL exited directly from the upper right abdomen (S group) or 82 cases of the double tunnel method (D group). There was no significant intergroup difference in age (41 vs 46; P = 0.05), male ratio 79% vs 67%, (p = 0.2), or BTB case (16% vs 31%, P = 0.1). Results DLI occurred in 12 cases (32%) in the S group and 14 cases (17%) in the D group (P = 0.1). The interval between the HM2 implantation and the first DLI occurrence was not significantly different (585 vs 414 days, P = 0.2). Treatment of the DLI was more conservative in the S group, where surgical DL translocation (DTL) was performed in 1 case (8%) in the S group and 10 cases (71%) in the D group (P l0.01). The DTL resulted in primary cure 1 case of the S group (100%) and 8 cases of the D group (80%). The 2 cases who failed to show primary cure post-DTL underwent pump exchange. The medical therapy and/or local irrigation was selected as the primary treatment of DLI in 8 cases of the S group (67%) and in 4 cases of the D group (29%) As a result, 1 case of the S group and 1 case of the D group showed the primary cure, whereas the remaining 10 cases (83%) continued daily wound care and intravenous antibiotics in hospital. Conclusion DLI occurred one year or more after durable VAD implantation on average, regardless of the driveline derivation method. The double tunnel method contributed to opening the window for aggressive surgical treatment which more frequently resulted in a primary cure of the DLI than the conservative therapy.
- Published
- 2020
31. Pregnancy latency associated with oral compared to intravenous antibiotics following preterm premature rupture of membranes
- Author
-
Erica J. Hardy, Erika F. Werner, Phinnara Has, Linda A. Nelson, Dwight J. Rouse, and Martha B. Kole
- Subjects
Pregnancy ,Obstetrics and gynaecology ,business.industry ,Intravenous antibiotics ,Anesthesia ,medicine ,Obstetrics and Gynecology ,Latency (engineering) ,medicine.disease ,business ,Premature rupture of membranes - Published
- 2019
32. Large pediatric sphenoid sinus cholesterol granuloma: Case report and review of the literature
- Author
-
Sri Kiran Chennupati, Andrew Mallon, and Erica Poletto
- Subjects
Nasal cavity ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Surgery ,Cholesterol granuloma ,medicine.anatomical_structure ,Paranasal sinuses ,Otorhinolaryngology ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,Medicine ,Radiology ,Headaches ,medicine.symptom ,business ,Pathological ,Sinus (anatomy) - Abstract
Cholesterol granulomas are rare lesions in the paranasal sinuses, especially in children. Symptoms are nonspecific depending on the localization and extent of the mass. In a 6-year-old boy who presented with a headache and proptosis, computed tomography and magnetic resonance imaging showed a large expansile mass in the nasal cavity. The patient was started on intravenous antibiotics with no improvement. Following endoscopic biopsy, the mass was removed. Pathological findings were consistent with a cholesterol granuloma. Good clinical outcomes can be obtained with proper imaging studies. Endoscopic sinus surgical techniques allow the surgeon to clear and drain the affected sinus cavity.
- Published
- 2014
33. Gemella sanguinis endocarditis: First case report in Taiwan and review of the literature
- Author
-
Ching-Huei Yang and Kuei-Ton Tsai
- Subjects
Aortic valve ,Male ,medicine.medical_specialty ,ved/biology.organism_classification_rank.species ,Heart Valve Diseases ,Taiwan ,Penicillins ,Transcatheter Aortic Valve Replacement ,Aortic valve replacement ,medicine ,Gemella ,Endocarditis ,Humans ,Gemella sanguinis ,Gram-Positive Bacterial Infections ,Aged ,Medicine(all) ,lcsh:R5-920 ,biology ,business.industry ,ved/biology ,valvular heart disease ,General Medicine ,Endocarditis, Bacterial ,medicine.disease ,biology.organism_classification ,Surgery ,Anti-Bacterial Agents ,medicine.anatomical_structure ,Infective endocarditis ,Intravenous antibiotics ,endocarditis ,cardiovascular system ,lcsh:Medicine (General) ,business - Abstract
We describe a case of infective endocarditis of the native aortic valve due to Gemella sanguinis in a 67-year-old Taiwanese man who had pre-existent valvular heart disease. He was successfully treated with aortic valve replacement accompanying a 6-week intravenous antibiotic treatment. To the best of our knowledge, this is the first report of G sanguinis endocarditis in Taiwan.
- Published
- 2014
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34. Small Bowel and Colon Perforation
- Author
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Carlos V.R. Brown
- Subjects
Resuscitation ,medicine.medical_specialty ,Colon ,Perforation (oil well) ,Peritonitis ,Infections ,Inflammatory bowel disease ,Diverticulitis, Colonic ,Colonic Diseases ,Pneumoperitoneum ,Ileum ,Ischemia ,Intestine, Small ,medicine ,Humans ,Radiation Injuries ,business.industry ,digestive, oral, and skin physiology ,Foreign Bodies ,Inflammatory Bowel Diseases ,medicine.disease ,digestive system diseases ,Surgery ,Bowel obstruction ,Intestinal Perforation ,Intravenous antibiotics ,business ,Colonic perforations ,Intestinal Obstruction - Abstract
For patients with small bowel and colonic perforations, a definitive diagnosis of the cause of perforation is not necessary before operation. Bowel obstruction and inflammatory bowel disease are the most common causes of nontraumatic intestinal perforations in industrialized countries, whereas infectious causes of intestinal perforations are more common in developing countries. Treatment of small bowel and colonic perforations generally includes intravenous antibiotics and fluid resuscitation, but the specific management of the bowel depends on the underlying cause of the perforation.
- Published
- 2014
35. Continuous beta-lactam intravenous antibiotic infusions for outpatient parenteral antimicrobial therapy
- Author
-
Hani Habayeb, Clive Grundy, Jayakeerthi Rangaiah, and Sebastien Van de Velde
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Treatment outcome ,Penicillins ,beta-Lactams ,Beta-lactam ,03 medical and health sciences ,chemistry.chemical_compound ,Internal medicine ,Outpatients ,medicine ,Humans ,Pharmacology (medical) ,Infusions, Intravenous ,Home Infusion Therapy ,business.industry ,Bacterial Infections ,General Medicine ,Antimicrobial ,United Kingdom ,Anti-Bacterial Agents ,Piperacillin, Tazobactam Drug Combination ,Treatment Outcome ,Infectious Diseases ,chemistry ,Intravenous antibiotics ,Costs and Cost Analysis ,business ,Piperacillin ,medicine.drug - Published
- 2018
36. One-Stage Exchange Revision Arthroplasty for the Treatment of Prosthetic Joint Infection: Rational and Technique
- Author
-
Brady K. Mock and Thomas K. Fehring
- Subjects
030222 orthopedics ,medicine.medical_specialty ,Joint arthroplasty ,Revision arthroplasty ,Prosthetic joint ,business.industry ,Prosthetic joint infection ,One stage ,030229 sport sciences ,Surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intravenous antibiotics ,medicine ,Orthopedics and Sports Medicine ,business - Abstract
Prosthetic joint infection is devastating complication of total joint arthroplasty and represents a significant burden both financially and to the patient's overall health. Challenges are in part due to difficulty in eradicating the disease and that there is no census in the most economical and effective techniques for treatment. In the United States the treatment standard is a 2-stage exchange in which the components are removed and an antibiotic spacer is placed, several weeks of intravenous antibiotics, and then a second procedure to remove the antibiotic spacer and place the final components. A 1-stage exchange removes the infected components and places new components in the same surgical setting. The success rate are similar between the 2 options but to date no large scale randomized study has been performed, however a 1-stage exchange limits the total number operations, decreases the morbidity associated in between stages, and is associated with a decrease in overall cost. Surgeons treating prosthetic joint infections should consider this technique.
- Published
- 2019
37. P119 Intravenous antibiotic prescriptions after phone consultation for cystic fibrosis patients
- Author
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Stephan Garcia, M. Diet, C. Dussart, V. Nave, M. Perceval, and Quitterie Reynaud
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,Medical prescription ,medicine.disease ,business ,Cystic fibrosis - Published
- 2019
38. P116 Intravenous antibiotic dosage survey of UK and Ireland adult cystic fibrosis centres
- Author
-
M.K. Dooney
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,medicine.disease ,business ,Cystic fibrosis - Published
- 2019
39. WS02-3-2 Predicting intravenous antibiotic usage with cardiopulmonary exercise testing in cystic fibrosis
- Author
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C.L. Bland, Owen W. Tomlinson, Patrick J. Oades, Craig A. Williams, N.J. Withers, David J. Wooldridge, and Christopher D. Sheldon
- Subjects
Pulmonary and Respiratory Medicine ,business.industry ,Anesthesia ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,Medicine ,Cardiopulmonary exercise testing ,business ,medicine.disease ,Cystic fibrosis - Published
- 2019
40. WS05-2 Empowering patients with cystic fibrosis to participate in the administration of intravenous antibiotics in hospital
- Author
-
J. Swarbrooke, N. Shaw, Christine Etherington, R. Metcalfe, A. Jones, Giulia Spoletini, Paul Whitaker, and Daniel Peckham
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,medicine.disease ,business ,Administration (government) ,Cystic fibrosis - Published
- 2019
41. Long-Term Peritoneal Dialysis May Result in Vascular Changes Within the Peritoneal Cavity, Leading to Reduced Efficacy of Intravenous Antibiotics in Treatment of Bacterial Peritonitis
- Author
-
Ruchir Trivedi, Snehal Naik, Attiya Haroon, and Hassan Bin Attique
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Bacterial Peritonitis ,medicine.medical_treatment ,030232 urology & nephrology ,Peritonitis ,Gastroenterology ,Peritoneal dialysis ,03 medical and health sciences ,Peritoneal cavity ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Peritoneal Cavity ,business.industry ,Continuous ambulatory peritoneal dialysis ,General Medicine ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,030104 developmental biology ,medicine.anatomical_structure ,Intravenous antibiotics ,Kidney Failure, Chronic ,business ,Peritoneal Dialysis - Published
- 2017
42. Adherence to NICE intravenous fluid therapy guidelines in general surgery emergency admissions, when accounting for administration of intravenous antibiotic in fluid
- Author
-
S. Robinson, C.L. Gelder, and A. McMahon
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Intravenous fluid ,business.industry ,Endocrinology, Diabetes and Metabolism ,Intravenous antibiotics ,Medicine ,Nice ,business ,Intensive care medicine ,Administration (government) ,computer ,computer.programming_language - Published
- 2018
43. Antibiothérapie intraveineuse des ostéomyélites aiguës : traitement long versus court
- Author
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M.N. Nessib, K. Gafsi, M. Trifa, W. Saied, Mahmoud Smida, M. Ben Ghachem, Sami Bouchoucha, and C. Ammar
- Subjects
medicine.medical_specialty ,business.industry ,Intravenous treatment ,Osteomyelitis ,medicine.disease ,Surgery ,Pharmacotherapy ,Chronic osteomyelitis ,Antibiotic therapy ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,Medicine ,Prospective randomized study ,Acute hematogenous osteomyelitis ,business - Abstract
The aim of this study was to evaluate the results of two antibiotic therapy protocols for osteomyelitis with different durations of intravenous treatment. This was a prospective randomized study of children treated for acute hematogenous osteomyelitis. Patients in group 1 (G1) received 7 days of intravenous antibiotics, whereas patients in group 2 (G2) received 14 days. Treatment was deemed effective if there were no signs of chronic osteomyelitis at the last follow-up. Fifty-three patients were included in the study (G1=27, G2=26). After a mean follow-up of 11.5 months, none of the patients in either group showed signs of chronic osteomyelitis. In conclusion, a shortened treatment of 7 days of intravenous antibiotic therapy is as effective as a longer treatment.
- Published
- 2013
44. Dynamic vascular changes following intravenous antibiotics in patients with cystic fibrosis
- Author
-
Timothy B.L. Ho, Charlotte E. Bolton, Rachel Garrod, John R. Cockcroft, Dennis J. Shale, James H. Hull, and R.K. Knight
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Spirometry ,Complete data ,medicine.medical_specialty ,Hemodynamics ,Inflammation ,Cystic fibrosis ,Stiffness ,Heart Rate ,Vascular ,Internal medicine ,medicine ,Humans ,In patient ,Pediatrics, Perinatology, and Child Health ,Infusions, Intravenous ,medicine.diagnostic_test ,business.industry ,Arteries ,medicine.disease ,Anti-Bacterial Agents ,Surgery ,C-Reactive Protein ,Blood pressure ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,Arterial ,Cardiology ,Female ,medicine.symptom ,business - Abstract
BackgroundAdults with cystic fibrosis (CF) have altered large artery haemodynamics which is associated with a persisting systemic inflammatory state. We hypothesized that a short-term intervention favorably influencing the inflammatory status may modify their haemodynamic state.MethodsAdult patients with CF were studied immediately preceding and following 2weeks of intravenous antibiotics. Large artery haemodynamics, principally heart rate-adjusted augmentation index (AIx) were obtained. Blood pressure (BP), spirometry and CRP were also measured.ResultsComplete data was available for 15 patients; mean (SD) age 28 (6)years. CRP was reduced while FEV1% predicted improved. Following treatment AIx was lower: 10.9 (10.9)% to 8.1 (10.9)% (p
- Published
- 2013
45. 126 Successful treatment of cepacia syndrome with a combination of intravenous antibiotics, oral cyclosporine and corticosteroids in a pediatric cystic fibrosis patient
- Author
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P. Ratto, L. Galanternik, S. Zaragoza, G. Manonelles, S. Lubovich, A. Teper, M. Vazquez, E. Biondi, Nora Sordelli, V. Rodriguez, and A. Fallo
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,010405 organic chemistry ,business.industry ,010402 general chemistry ,medicine.disease ,01 natural sciences ,Cystic fibrosis ,0104 chemical sciences ,Intravenous antibiotics ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Intensive care medicine ,business - Published
- 2017
46. Serratia marcescens bacteremia because of contaminated prefilled heparin and saline syringes: A multi-state report
- Author
-
Mark Hutchins, Roy F. Chemaly, Mary K. Hayden, Monica K. Sikka, Dhanesh B. Rathod, Jeffery Tarrand, Gorden Trenholme, Javier A. Adachi, Tracy Horn, Kim Nguyen, and Issam I Raad
- Subjects
Adult ,Male ,medicine.medical_specialty ,Fatal outcome ,Adolescent ,Epidemiology ,medicine.medical_treatment ,Bacteremia ,Sodium Chloride ,Disease Outbreaks ,Serratia Infections ,Young Adult ,medicine ,Humans ,Child ,Saline ,Serratia marcescens ,Aged ,Aged, 80 and over ,Cross Infection ,Multi state ,biology ,Heparin ,business.industry ,Syringes ,Health Policy ,Public Health, Environmental and Occupational Health ,Outbreak ,Middle Aged ,medicine.disease ,biology.organism_classification ,United States ,Anti-Bacterial Agents ,Surgery ,Treatment Outcome ,Infectious Diseases ,Intravenous antibiotics ,Female ,Drug Contamination ,business ,medicine.drug - Abstract
A national outbreak of Serratia marcescens bacteremia because of contaminated prefilled heparin and saline syringes led to their recall. We evaluated the clinical impact of this outbreak in 57 patients at 3 centers. All patients were symptomatic and were treated with intravenous antibiotics with a fatal outcome in 1 patient.
- Published
- 2011
47. Resolution of hypoglossal nerve palsy associated with retropharyngeal abscess after prompt medical and surgical treatment
- Author
-
Sally R. Shott, Bernadette L. Koch, Joel E. Mortensen, John H. Greinwald, Jeremy D. Prager, and Evan J. Propst
- Subjects
Hypoglossal Nerve Palsy ,medicine.medical_specialty ,business.industry ,Retropharyngeal abscess ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Tongue ,Intravenous antibiotics ,Anesthesia ,Cellulitis ,Concomitant ,Pediatrics, Perinatology and Child Health ,medicine ,Surgical treatment ,business - Abstract
Isolated hypoglossal nerve palsy due to retropharyngeal abscess is extremely rare. We report two patients with this finding, both of whom presented with concomitant retropharyngeal abscess/cellulitis. In one patient, the hypoglossal nerve palsy presented early in the course of the infection, whereas in the other patient, the hypoglossal nerve palsy occurred as the patient was clinically improving. Both patients were treated with intravenous antibiotics and surgical drainage. These cases suggest that hypoglossal nerve palsy should be an indication for aggressive therapy of a retropharyngeal abscess, and that hypoglossal nerve palsy may be reversible if managed expeditiously.
- Published
- 2011
48. P094 Design, enrollment, and feasibility of the STOP-2 randomised study of intravenous antibiotic treatment duration in cystic fibrosis pulmonary exacerbations
- Author
-
Valeria V. Beckett, Don B. Sanders, Donald R. VanDevanter, Sonya L. Heltshe, Christopher H. Goss, M. Skalland, Patrick A. Flume, and Natalie E. West
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Treatment duration ,medicine.disease ,Cystic fibrosis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,030212 general & internal medicine ,business ,030217 neurology & neurosurgery - Published
- 2018
49. P221 Home intravenous antibiotics: behind closed doors
- Author
-
A.L. Hopkins, Jamie Duckers, A. Smith, and R.I. Ketchell
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,Doors ,medicine.disease ,Intensive care medicine ,business ,Cystic fibrosis - Published
- 2018
50. P092 A service evaluation addressing: are intravenous antibiotics administered at home as clinically effective as intravenous antibiotics administered in hospital in cystic fibrosis patients in the adult cystic fibrosis centre in Aberdeen?
- Author
-
S. Steele
- Subjects
Pulmonary and Respiratory Medicine ,Service (business) ,medicine.medical_specialty ,business.industry ,Internal medicine ,Intravenous antibiotics ,Pediatrics, Perinatology and Child Health ,medicine ,medicine.disease ,business ,Cystic fibrosis - Published
- 2018
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