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1. An NLP Solution to Foster the Use of Information in Electronic Health Records for Efficiency in Decision-Making in Hospital Care

Author

Leite-Moreira, Adelino, Mendes, Afonso, Pedrosa, Afonso, Rocha-Sousa, Amândio, Azevedo, Ana, Amaral-Gomes, André, Pinto, Cláudia, Figueira, Helena, Pereira, Nuno Rocha, Mendes, Pedro, and Pimenta, Tiago

Subjects
Computer Science - Computation and Language, Computer Science - Computers and Society
Abstract

The project aimed to define the rules and develop a technological solution to automatically identify a set of attributes within free-text clinical records written in Portuguese. The first application developed and implemented on this basis was a structured summary of a patient's clinical history, including previous diagnoses and procedures, usual medication, and relevant characteristics or conditions for clinical decisions, such as allergies, being under anticoagulant therapy, etc. The project's goal was achieved by a multidisciplinary team that included clinicians, epidemiologists, computational linguists, machine learning researchers and software engineers, bringing together the expertise and perspectives of a public hospital, the university and the private sector. Relevant benefits to users and patients are related with facilitated access to the patient's history, which translates into exhaustiveness in apprehending the patient's clinical past and efficiency due to time saving., Comment: 11 pages, 2 figures

Published
2022

10. Primary drug resistance at diagnosis of HIV‐1 infection: a Portuguese cohort

Author

Pereira, Nuno Rocha, Duro, Raquel, Piñero, Carmela, Figueiredo, Cristóvão, Santos, Ana Sofia, Soares, Jorge, Serrão, Rosário, and Sarmento, António

Subjects
Gene mutations -- Identification and classification -- Health aspects, Antiviral agents -- Patient outcomes, Drug resistance -- Genetic aspects, HIV infection -- Diagnosis -- Drug therapy -- Genetic aspects, Health
Abstract

Introduction: Presence of viral mutations conferring resistance to antiretroviral drugs has potential impact on success of antiretroviral therapy (ART). The aim of this study was to describe the prevalence of resistance‐associated mutations in HIV‐infected patients without prior ART in a Portuguese cohort. Materials and Methods: Retrospective single‐centre study of patients newly diagnosed with HIV‐1 infection between 2006 and 2012. Resistance genotyping was obtained with HIV TRUGENE[sup.®] and Viroseq[sup.®] tests and the analysis of drug resistance was based on the Stanford University HIV Drug Resistance Database. Epidemiological data was also gathered. Continuous variables were summarized by mean and standard deviation, whereas categorical variables were presented as proportions. Comparison of proportions was performed with Chi square and Fisher exact test while means were compared with Student test. Statistical significance was assumed when p Results: Resistance testing was performed in 624 patients. General characteristics of the patients are summarized in Table 1. Mutations were found in 291 (46.6%) patients but resistance‐associated mutations were present in 79 (12.7%) patients. Resistances to different drug classes were the following: NNRTIs‐resistance in 42 (6.7%) patients; NRTIs‐resistance in 19 (3.0%) patients; PIs‐resistance in 30 (4.8%) patients. Only 10 (1.6%) patients presented simultaneous resistance‐associated mutations to more than one class of drugs. There were no statistical significant differences between the years at which HIV‐1 was diagnosed. Also no significant difference in the distribution of the parameters age, sex, CD4‐cell count, and viral load, between groups with and without resistance was identified. Resistance‐associated mutations were significantly more common in patients with non‐B HIV‐1 subtypes (15.4% vs 9.8%; p=0.048) and in those presenting with AIDS (18.2% vs 11.1%; p=0.03). Conclusions: Prevalence of resistance‐associated mutations identified in this study was similar to those reported in similar studies from Western Europe. Knowledge about the epidemiology of primary resistance in our country is important in order to improve HIV care., Table 1: General characteristics of the patients. Abbreviations used in the table: SD ‐ Standard deviation; MSM ‐ Men that have sex with men; CD4 ‐ CD4+ T cell lymphocytes [...]

Published
2014
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11. Characterization of HIV‐1 subtypes in a Portuguese cohort

Author

Pereira, Nuno Rocha, Duro, Raquel, Piñero, Carmela, Malheiro, Luís, Soares, Jorge, Serrão, Rosário, and Sarmento, António

Subjects
Medicine, Preventive -- Research, Prevalence studies (Epidemiology) -- Methods, Preventive health services -- Research, AIDS (Disease) -- Research, AIDS research, HIV infection -- Diagnosis -- Demographic aspects, Health
Abstract

Introduction: Distribution of HIV‐1 subtypes is variable around the world, with the most common subtype in western Europe being subtype B. The aim our study was to describe the prevalence of different HIV‐1 subtypes in newly diagnosed patients and identify demographic and epidemiological characteristics related with different subtypes. Materials and Methods: Retrospective single‐centre study of patients newly diagnosed with HIV‐1 infection between 2006 and 2012. Epidemiological data was gathered and genotyping was performed in each patient identified. Demographic and epidemiological characteristics were compared between patients with subtype B and other subtypes. Continuous variables were summarized by mean and standard deviation whereas categorical variables were presented as proportions. Comparison of groups was performed using the Chi square, Fisher exact test and Student T test. Statistical significance was assumed when p Results: In the period of the study, 624 patients newly diagnosed with HIV‐1 infection were submitted to genotypic testing but information about subtype was available only for 592 patients. General characteristics of the patients are summarized in Table 1. The distribution of the identified subtypes was the following: 286 (48.3%) patients had subtype B, 157 (26.5%) had subtype G, 54 (9.1%) had subtype C, 36 (6.1%) had subtype A, 32 (5.4%) had subtype F and 25 (4.2%) had CRF's. Patients with subtype B were more commonly male (p=0.001) and younger (p Conclusions: The most commonly identified subtype was B in accordance with previous reports from other western European countries. However, in our cohort the proportion of non‐B subtypes is higher than that reported for other European countries, probably reflecting the influence of strong bonds with Portuguese speaking African countries. Knowledge about HIV subtypes distribution may help understanding transmission dynamics and can be an important tool in the design of preventive measures., Table 1: General characteristics of the patients Characteristics n=592 Sex Male 425 (71.8%) Female 167 (28.2%) Age (mean±SD) 40.78±13.45 Risk for HIV acquisition Heterosexual 410 (69.5%) MSM 132 (22.2%) Injecting [...]

Published
2014
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12. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., and Catena, Fausto

Abstract

Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: T

Published
2017

13. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship—results from an international cross-sectional survey

Author

Sartelli, Massimo, primary, Labricciosa, Francesco M., additional, Barbadoro, Pamela, additional, Pagani, Leonardo, additional, Ansaloni, Luca, additional, Brink, Adrian J., additional, Carlet, Jean, additional, Khanna, Ashish, additional, Chichom-Mefire, Alain, additional, Coccolini, Federico, additional, Di Saverio, Salomone, additional, May, Addison K., additional, Viale, Pierluigi, additional, Watkins, Richard R., additional, Scudeller, Luigia, additional, Abbo, Lilian M., additional, Abu-Zidan, Fikri M., additional, Adesunkanmi, Abdulrashid K., additional, Al-Dahir, Sara, additional, Al-Hasan, Majdi N., additional, Alis, Halil, additional, Alves, Carlos, additional, Araujo da Silva, André R., additional, Augustin, Goran, additional, Bala, Miklosh, additional, Barie, Philip S., additional, Beltrán, Marcelo A., additional, Bhangu, Aneel, additional, Bouchra, Belefquih, additional, Brecher, Stephen M., additional, Caínzos, Miguel A., additional, Camacho-Ortiz, Adrian, additional, Catani, Marco, additional, Chandy, Sujith J., additional, Jusoh, Asri Che, additional, Cherry-Bukowiec, Jill R., additional, Chiara, Osvaldo, additional, Colak, Elif, additional, Cornely, Oliver A., additional, Cui, Yunfeng, additional, Demetrashvili, Zaza, additional, De Simone, Belinda, additional, De Waele, Jan J., additional, Dhingra, Sameer, additional, Di Marzo, Francesco, additional, Dogjani, Agron, additional, Dorj, Gereltuya, additional, Dortet, Laurent, additional, Duane, Therese M., additional, Elmangory, Mutasim M., additional, Enani, Mushira A., additional, Ferrada, Paula, additional, Esteban Foianini, J., additional, Gachabayov, Mahir, additional, Gandhi, Chinmay, additional, Ghnnam, Wagih Mommtaz, additional, Giamarellou, Helen, additional, Gkiokas, Georgios, additional, Gomi, Harumi, additional, Goranovic, Tatjana, additional, Griffiths, Ewen A., additional, Guerra Gronerth, Rosio I., additional, Haidamus Monteiro, Julio C., additional, Hardcastle, Timothy C., additional, Hecker, Andreas, additional, Hodonou, Adrien M., additional, Ioannidis, Orestis, additional, Isik, Arda, additional, Iskandar, Katia A., additional, Kafil, Hossein S., additional, Kanj, Souha S., additional, Kaplan, Lewis J., additional, Kapoor, Garima, additional, Karamarkovic, Aleksandar R., additional, Kenig, Jakub, additional, Kerschaever, Ivan, additional, Khamis, Faryal, additional, Khokha, Vladimir, additional, Kiguba, Ronald, additional, Kim, Hong B., additional, Ko, Wen-Chien, additional, Koike, Kaoru, additional, Kozlovska, Iryna, additional, Kumar, Anand, additional, Lagunes, Leonel, additional, Latifi, Rifat, additional, Lee, Jae G., additional, Lee, Young R., additional, Leppäniemi, Ari, additional, Li, Yousheng, additional, Liang, Stephen Y., additional, Lowman, Warren, additional, Machain, Gustavo M., additional, Maegele, Marc, additional, Major, Piotr, additional, Malama, Sydney, additional, Manzano-Nunez, Ramiro, additional, Marinis, Athanasios, additional, Martinez Casas, Isidro, additional, Marwah, Sanjay, additional, Maseda, Emilio, additional, McFarlane, Michael E., additional, Memish, Ziad, additional, Mertz, Dominik, additional, Mesina, Cristian, additional, Mishra, Shyam K., additional, Moore, Ernest E., additional, Munyika, Akutu, additional, Mylonakis, Eleftherios, additional, Napolitano, Lena, additional, Negoi, Ionut, additional, Nestorovic, Milica D., additional, Nicolau, David P., additional, Omari, Abdelkarim H., additional, Ordonez, Carlos A., additional, Paiva, José-Artur, additional, Pant, Narayan D., additional, Parreira, Jose G., additional, Pędziwiatr, Michal, additional, Pereira, Bruno M., additional, Ponce-de-Leon, Alfredo, additional, Poulakou, Garyphallia, additional, Preller, Jacobus, additional, Pulcini, Céline, additional, Pupelis, Guntars, additional, Quiodettis, Martha, additional, Rawson, Timothy M., additional, Reis, Tarcisio, additional, Rems, Miran, additional, Rizoli, Sandro, additional, Roberts, Jason, additional, Pereira, Nuno Rocha, additional, Rodríguez-Baño, Jesús, additional, Sakakushev, Boris, additional, Sanders, James, additional, Santos, Natalia, additional, Sato, Norio, additional, Sawyer, Robert G., additional, Scarpelini, Sandro, additional, Scoccia, Loredana, additional, Shafiq, Nusrat, additional, Shelat, Vishalkumar, additional, Sifri, Costi D., additional, Siribumrungwong, Boonying, additional, Søreide, Kjetil, additional, Soto, Rodolfo, additional, de Souza, Hamilton P., additional, Talving, Peep, additional, Trung, Ngo Tat, additional, Tessier, Jeffrey M., additional, Tumbarello, Mario, additional, Ulrych, Jan, additional, Uranues, Selman, additional, Van Goor, Harry, additional, Vereczkei, Andras, additional, Wagenlehner, Florian, additional, Xiao, Yonghong, additional, Yuan, Kuo-Ching, additional, Wechsler-Fördös, Agnes, additional, Zahar, Jean-Ralph, additional, Zakrison, Tanya L., additional, Zuckerbraun, Brian, additional, Zuidema, Wietse P., additional, and Catena, Fausto, additional

Published
2017
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17. How can multi-professional education support better stewardship?

Author

Pereira, Nuno Rocha, Castro-Sanchez, Enrique, and Nathwani, Dilip

Subjects
*DRUG resistance in bacteria, *ANTI-infective agents, *MEDICAL personnel, *MEDICAL education, *MEDICAL care
Abstract

Antimicrobial stewardship is widely accepted as an efficient strategy to combat the growing threat of antimicrobial resistance. Education is one of the cornerstones of successful antimicrobial stewardship programs. There is also general agreement that antimicrobial stewardship is a team effort that must involve the whole continuum of healthcare workers. Providing adequate education for all different professionals although challenging is deemed crucial to achieve good results. This paper reviews the different strategies available to educate the multiple healthcare workers, discusses how education can improve antimicrobial stewardship programs and outlines some of the challenges faced and research gaps that need to be addressed in order to improve education in this field. [ABSTRACT FROM AUTHOR]

Published
2017
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19. The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Federico Coccolini, Leonel Lagunes, André Ricardo Araujo da Silva, Massimo Sartelli, Sara Al-Dahir, Young R. Lee, Mario Tumbarello, Faryal Khamis, Natalia Santos, Jean Carlet, Fausto Catena, Agron Dogjani, Jan Ulrych, Isidro Martinez Casas, András Vereczkei, Salomone Di Saverio, Sydney Malama, Harry van Goor, Garima Kapoor, Hong Bin Kim, Norio Sato, Gustavo M. Machain, Chinmay Gandhi, Iryna Kozlovska, Ramiro Manzano-Nunez, Katia Iskandar, Fikri M. Abu-Zidan, Sujith J Chandy, Rosio Isabel Guerra Gronerth, Therese M. Duane, Lena M. Napolitano, Carlos A. Ordoñez, Yonghong Xiao, Michael McFarlane, Cristian Mesina, Sanjay Marwah, Goran Augustin, Tatjana Goranovic, Bruno M. Pereira, Ivan Kerschaever, Timothy Craig Hardcastle, Marcelo A. Beltrán, Stephen Y. Liang, Julio C. Haidamus Monteiro, Vishalkumar G Shelat, Kuo Ching Yuan, Sandro Scarpelini, Narayan Dutt Pant, Martha Quiodettis, Carlos Alves, Mutasim M. Elmangory, Céline Pulcini, Addison K. May, Guntars Pupelis, Selman Uranues, Pamela Barbadoro, Sandro Rizoli, Ernest E. Moore, Rifat Latifi, Ashish Khanna, Hossein Samadi Kafil, Richard R. Watkins, Boonying Siribumrungwong, Abdelkarim H. Omari, Agnes Wechsler-Fördös, Lewis J. Kaplan, Nusrat Shafiq, Jason A. Roberts, Warren Lowman, Laurent Dortet, Stephen M. Brecher, Luca Ansaloni, Rodolfo Soto, Tanya L. Zakrison, Sameer Dhingra, Jacobus Preller, Eleftherios Mylonakis, Wagih Ghnnam, Asri Che Jusoh, Pierluigi Viale, Costi D. Sifri, Miklosh Bala, José Gustavo Parreira, Alfredo Ponce-de-León, Jae G. Lee, Jakub Kenig, Kjetil Søreide, Halil Alis, Lilian M. Abbo, Mahir Gachabayov, Marco Catani, Ronald Kiguba, Jean-Ralph Zahar, Wietse P. Zuidema, Robert G. Sawyer, Loredana Scoccia, Nuno Pereira, Vladimir Khokha, Ionut Negoi, Aneel Bhangu, Michał Pędziwiatr, Helen Giamarellou, Garyphallia Poulakou, Shyam Kumar Mishra, Francesco Di Marzo, Jeffrey M. Tessier, Boris Sakakushev, Milica D. Nestorovic, Hamilton Petry de Souza, Tarcisio Reis, Yousheng Li, Dominik Mertz, Andreas Hecker, Ngo Tat Trung, Anand Kumar, Belefquih Bouchra, Leonardo Pagani, James M. Sanders, AA Munyika, Brian S. Zuckerbraun, Souha S. Kanj, Arda Isik, Luigia Scudeller, Adrien Hodonou, Philip S. Barie, Marc Maegele, Jill R. Cherry-Bukowiec, Peep Talving, Orestis Ioannidis, Miran Rems, Oliver A. Cornely, Harumi Gomi, Ewen A. Griffiths, Mushira Enani, Zaza Demetrashvili, Gereltuya Dorj, Piotr Major, Miguel Caínzos, Ari Leppäniemi, Jesús Rodríguez-Baño, Wen Chien Ko, Ziad A. Memish, Osvaldo Chiara, Elif Colak, José Artur Paiva, A R K Adesunkanmi, Timothy M. Rawson, Georgios Gkiokas, Paula Ferrada, Francesco M. Labricciosa, Alain Chichom-Mefire, Jan J. De Waele, Yunfeng Cui, Adrián Camacho-Ortiz, J. Esteban Foianini, Majdi N. Al-Hasan, Belinda De Simone, David P. Nicolau, Kaoru Koike, Athanasios Marinis, Florian M.E. Wagenlehner, Aleksandar Karamarkovic, Adrian Brink, Emilio Maseda, II kirurgian klinikka, Department of Surgery, Clinicum, HUS Abdominal Center, Surgery, Other Research, Università degli Studi di Macerata = University of Macerata (UNIMC), Università Politecnica delle Marche [Ancona] (UNIVPM), Central Hospital [Bolzano, Italy], Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Milpark Hospital (Milpark Hospital), Milpark Hospital, University of Cape Town, World Alliance against Antibiotics Resistance, Cleveland Clinic, Regional Hospital, Limbe, Rimini Infermi Hospital, Maggiore Hospital, Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], University of Bologna, Northeastern Ohio Medical University (NEOMED), Foundation IRCCS Policlinico San Matteo, University of Miami Leonard M. Miller School of Medicine (UMMSM), United Arab Emirates University (UAEU), Obafemi Awolowo University (OAU), Xavier University of Louisiana, University of South Carolina School of Medicine, Columbia, South Carolina, Training Hospital Istanbul, Hospital de São João [Porto], Centro de Investigação em Estudos da Criança (CIEC), Universidade do Minho, University Hospital Center Zagreb, Hadassah Hebrew University Medical Center [Jerusalem], Weill Cornell Medicine [New York], Universidad de La Serena (USERENA), Queens Elizabeth Hospital [Birmingham], Université Internationale de Casablanca (UIC), VA Boston Healthcare System, Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of psychiatry-King‘s College London, University Hospital of Cologne [Cologne], 4th Department of Internal Medicine, University of Athens Medical School [Athens], Center for Visual Information Technology [Hyderabad] (CVIT), International Institute of Information Technology, Hyderabad [Hyderabad] (IIIT-H), Chonnam National University [Gwangju], Shanghai Jiaotong University, University of Houston, Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto, Unité de biostatistiques, CHU Clermont-Ferrand, ATTIKON University General Hospital, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Duke University Marine Laboratory, University Hospital Virgen Macarena, Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sartelli, M, Labricciosa, FM, Barbadoro, P, Pagani, L, Dorj, G, Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlo, Araujo da Silva, André R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltrán, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Caínzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Esteban Foianini, J., Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgio, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andrea, Hodonou, Adrien M., Ioannidis, Oresti, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasio, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, Shyam K., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherio, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, José-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, Bruno M., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobu, Pulcini, Céline, Pupelis, Guntar, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodríguez-Baño, Jesú, Sakakushev, Bori, Sanders, Jame, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Søreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andra, Wagenlehner, Florian, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Fördös, Agne, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, and Zuidema, Wietse P.

Subjects
0301 basic medicine, Cross-sectional study, Psychological intervention, Antibiotics, Antimicrobial stewardship, Infections, Surgery, Anti-Infective Agents, Antimicrobial Stewardship, Cross-Sectional Studies, Global Health, Humans, Intraabdominal Infections, Postoperative Complications, Surveys and Questionnaires, GUIDELINES, HEALTH-CARE EPIDEMIOLOGY, 0302 clinical medicine, Global health, Medicine and Health Sciences, PROGRAM, Infection control, Medicine, 030212 general & internal medicine, Response rate (survey), DISEASES SOCIETY, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], CIRURGIA, Emergency Medicine, Infection, Life Sciences & Biomedicine, medicine.medical_specialty, 030106 microbiology, lcsh:Surgery, MEDLINE, 03 medical and health sciences, Antibiotic resistance, AMERICA, Science & Technology, business.industry, Antibiotic, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, HOSPITALS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Contains fulltext : 177987.pdf (Publisher’s version ) (Open Access) BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.

Published
2017

20. Prozone-like phenomenon in travellers with fatal malaria: report of two cases.

Author

Santos L, Pereira NR, Andrade P, Dias PF, Alves CL, Abreu C, Serrão R, Ribeiro M, and Sarmento A

Subjects
Adult, False Negative Reactions, Fatal Outcome, Humans, Male, Middle Aged, Malaria, Falciparum diagnosis, Serologic Tests methods
Abstract

Malaria diagnosis remains a concern in non-endemic countries, with rapid diagnosis being crucial to improve patients' outcome. Rapid diagnostic tests have high sensitivity but they also have flaws and false-negative results that might jeopardize malaria diagnosis. Some false-negative results might relate to a prozone-like effect. The authors describe two patients with false-negative rapid diagnostic tests in which a prozone-like effect might have been involved. The authors highlight that these tests should not be used without accompanying light microscopy observation of blood films and discuss potential benefits of using rapid diagnostic tests with more than one specific antigen for Plasmodium falciparum.

Published
2015
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