Drugs for hypertension.
Treat Guidel Med Lett. 2009 Jan;7(77):1-10; quiz 2 p
PMID: 19107095 [PubMed - indexed for MEDLINE]Link to Article at PubMed
Patient perception of osteopathic manipulative treatment in a hospitalized setting: a survey-based study.
J Am Osteopath Assoc. 2008 Nov;108(11):665-8
Authors: Pomykala M, McElhinney B, Beck BL, Carreiro JE
CONTEXT: Although many studies on the effects of osteopathic manipulative treatment (OMT) have been published, few examine its role in treating hospitalized patients. OBJECTIVE: To determine patient perception of receiving OMT while hospitalized. METHODS: Patients were referred to receive OMT through a consultation service and were separated into four groups: medical, musculoskeletal, obstetric, or postsurgical. The same osteopathic physician treated each patient and used various OMT techniques as needed. High-velocity, low-amplitude was not used. Patient perceptions were assessed 24 hours after treatment using a 10-question survey. Main outcome measures included pain, need for pain medication, anxiety about hospitalization, and overall comfort level. RESULTS: Of the 195 hospitalized patients who received OMT, 160 (82%) returned the survey. Of these patients, 43% reported a decreased need for pain medication, 74% indicated a decrease in pain, 90% had reduced anxiety, and 98% reported that OMT improved their overall comfort level. In addition, 94% of patients felt OMT was helpful for their recovery, and 98% would recommend OMT for other hospitalized patients. CONCLUSION: Osteopathic manipulative treatment may be of tremendous benefit to hospitalized patients, regardless of their diagnoses.
PMID: 19011230 [PubMed - indexed for MEDLINE]Link to Article at PubMed
Single-step EUS-guided endoscopic treatment for sterile pancreatic collections: a single-center experience.
Dig Dis. 2008;26(4):370-6
Authors: Ardengh JC, Coelho DE, Coelho JF, de Lima LF, dos Santos JS, Módena JL
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS) is useful for the treatment of sterile pancreatic fluid collections (PFC), either by means of transmural drainage or by complete aspiration. The aim of this study was to evaluate the efficacy and safety of single-step EUS-guided endoscopic approaches for treatment of sterile PFC. PATIENTS AND METHODS: During a 3-year period, 77 consecutive patients with symptomatic, persistent sterile PFC were evaluated and treated with the linear EUS. We excluded patients with grossly purulent collections, chronic pseudocyst and those whose cytology diagnostic was neoplastic cyst of pancreas. 44 patients received a single 10-Fr plastic straight stent under EUS or fluoroscopic control (group I) and 33 of these underwent a single-step complete aspiration with a 19-gauge needle (group II). RESULTS: The mean size of the sterile PFC was 48 mm in group I and 28 mm in group II (p < 0.001). Overall, endoscopic treatment was successful in 70 (90.9%) patients. The mean volume aspirated was 25 (18-65) ml. The total number of procedures was 50 in group I and 41 punctures in group II. After a mean follow-up of 64 +/- 15.6 weeks there were 6 complications (13.6%): 2 recurrences (referred to surgery), 2 developing abscesses (submitted a new EUS-guided endoscopic drainage with success), 1 perforation that died (2.2%), and 1 case of bleeding (sent to surgery) in group I. In group II there were only 6 (18.1%) recurrences (submitted a new EUS-guided aspiration). None of the patients undergoing single-step aspiration developed infections, perforation or hemorrhage. CONCLUSION: The recurrence of pancreatic pseudocysts after endoscopic treatment was similar, either by means of plastic stents or by complete single-step aspiration.
PMID: 19188730 [PubMed - indexed for MEDLINE]Link to Article at PubMed
Therapeutic challenges in the era of antibiotic resistance.
Int J Antimicrob Agents. 2008 Dec;32 Suppl 4:S197-9
Authors: Lee C
Multidrug microbial resistance poses major challenges to the management of infection, particularly with the paucity of new drugs with activity against these bacteria. Since the turn of this century a few new antibiotics have been licensed, including linezolid, daptomycin and tigecycline. This supplement reports data presented at the 13th International Congress of Infectious Diseases held in Kuala Lumpur in June 2008. Dr R. Isturiz reviews the data on global resistance trends and the potential impact on empirical therapy; Dr J.-H. Song reviews new agents on the antimicrobial horizon; and the final paper in the supplement, by Dr L.R. Peterson, reviews the role of tigecycline in the management of complicated intra-abdominal and skin and soft tissue infections.
PMID: 19134519 [PubMed - indexed for MEDLINE]Link to Article at PubMed
What's new on the antimicrobial horizon?
Int J Antimicrob Agents. 2008 Dec;32 Suppl 4:S207-13
Authors: Song JH
The antimicrobial era is threatened by high levels of antibiotic resistance, the limited number and disparate availability of effective antibiotics against diverse bacterial species, and reduced involvement by the pharmaceutical industry in the development of new anti-infectives. For the treatment of resistant Gram-positive coccal infections, particularly methicillin-resistant staphylococcal infections, vancomycin has long been the mainstay antimicrobial agent due to its safety, durability against resistance, and lack of other approved alternatives. However, the efficacy and safety of vancomycin for the treatment of many serious infections has been called into question. Promising results from clinical trials suggest that five new antimicrobials could offer safe and effective alternatives to vancomycin. With regard to resistant Gram-negative infections, new carbapenems and some other options will be available. This paper reviews the safety and efficacy of these new antimicrobial agents against resistant bacterial pathogens.
PMID: 19134521 [PubMed - indexed for MEDLINE]Link to Article at PubMed
A review of tigecycline--the first glycylcycline.
Int J Antimicrob Agents. 2008 Dec;32 Suppl 4:S215-22
Authors: Peterson LR
The dawn of a troubling post-antibiotic era likely is on the horizon, fuelled by a rise in bacterial resistance to existing antibiotic therapy alongside a waning pipeline of novel antibacterial agents. Tigecycline, a new glycylcycline with an expanded broad spectrum of in vitro activity, was recently approved for the treatment of complicated skin and soft tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs). This review will examine how tigecycline evades the common mechanisms of antibiotic resistance, the metabolism and pharmacokinetics of tigecycline, and its spectrum of in vitro activity. The results of randomized clinical trials for the treatment of cSSTIs and cIAIs with tigecycline are also described, as is the patient safety and tolerability observed during these studies. Tigecycline monotherapy has been shown to be as effective as its comparators and, against a backdrop of rising bacterial resistance, the role for tigecycline in monotherapy of infections from Gram-positive, Gram-negative and anaerobic bacteria is a meaningful development.
PMID: 19134522 [PubMed - indexed for MEDLINE]Link to Article at PubMed