Search

Acinetobacter baumannii is one of the most important nosocomial pathogens, and its multiple antibiotic resistance has emerged as an obstacle in the treatment of these infections worldwide.To identify risk factors of mortality for A. baumannii bacteraemia.A retrospective cohort study of 72 patients with significant A. baumannii bacteraemia was conducted to evaluate risk factors for mortality.The median age of the 72 enrolled patients was 48 years, 96% of the cases were hospital-acquired, and the bacteraemia-related mortality rate was 29% (21 of 72 patients). Univariate analysis revealed that the risk factors for mortality included: an elevated acute physiology and chronic health evaluation (APACHE II) score, receipt of in vitro ineffective definitive antimicrobial therapy, in vitro A. baumannii resistance to cefoperazone/ sulbactam, neutropenia, and presentation with septic shock. Multivariate analysis reveals that the independent risk factors for mortality are neutropenia and elevated APACHE II scores.Risk factors such as neutropenia and elevated APACHE II scores are found to be associated with higher mortality rates of A. baumannii bacteraemia. Further study is necessary for the determination of optimal strategies for both the prevention and treatment of these infections.

The one-stage total ear reconstruction (auricular reconstruction and tympanoplasty) has a number of merits. 1. Satisfactory esthetic results obtained in one operation. 2. The "super thin" skin flap is elevated on a plane that excludes hair follicles from the flap, so the hair-bearing areas of the scalp can be readily incorporated as part of the ear reconstruction. 3. The reconstructed ear has adequate blood supply and protective sensation. 4. The surgeon may choose to carry out a tympanoplasty and obtain restoration of auditory function or may choose to carry out a pseudomeatus procedure and reduce the operating time. We feel that the "super thin" skin flap and the simultaneous tympanoplasty are valuable supplements to ear reconstruction. The functional results of the tympanoplasty must be considered only a partial success at this time; long-term evaluation as well as technologic improvements are needed.

A series of 18 patients of transaxillary incision augmentation mammoplasties has been presented. The axillary incision was 3.5 to 4 cm long and healed inconspicuously. The silicon gel implants were put in under pectoral major muscle. Follow-up time was six months to 4 1/2 years. The results of all patients were satisfactory. All patients were graded into Baker's I. No capsular contraction was developed. This obvious difference between Chinese women and western women of capsular contraction after augmentation mammoplasties may be due to the difference of human race. But a future research should be designed and performed.