Irish journal of medical science
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Modification of antibiotic prophylaxis prior to transrectal ultrasound-guided prostate biopsy (TRUSPB) based on pre-procedure rectal culture results is effective for prevention of infection from fluoroquinolone (FQ)-resistant and extended-spectrum beta-lactamase (ESBL) Escherichia coli strains. This has several implications for service delivery and cost. Our aim was to audit sepsis rates after introduction of ESBL screening and to identify risk factors for FQ resistance in ESBL strains and factors for sepsis risk. ⋯ In the face of rising TRUSPB sepsis and higher sepsis rates with ESBL carriers despite additional prophylaxis, introduction of a targeted antibiotic prophylaxis prior to TRUSPB sepsis prostate biopsies based on rectal swabs or urine cultures may reduce sepsis rates or clinicians may find themselves leaning towards increasingly performing transperineal biopsies with lower sepsis rates supporting the 'trexit' initiative.
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Axillary hyperhidrosis is a common complaint affecting 5% of the general population. It can significantly impact quality of life (QOL) and may be extremely debilitating. Administration of intra-dermal botulinum toxin type-A (Botox) has been proven to be effective in managing axillary hyperhidrosis; however, to date, no long-term data has assessed its efficacy. ⋯ These data suggest that the established early QOL benefits associated with intra-dermal botox administration for AH are sustained in the long term. This benefit was seen across all subsets of the DLQI tool.
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The magnitude of effects of lean mass and fat mass on bone health is controversial, and this study is a contribution to understand its effects on skeletal composition. ⋯ Both lean mass and fat mass are significant predictors of BMD. To preserve BMD maintenance or increase of lean mass is more effective than fat mass. BMI correlates well with body composition; however, we recommend the use of direct measures of body fat and muscle to make this relation more interpretable. Total Body DXA is a readily available diagnostic tool which provides high-valued information about body composition.
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Bisphosphonates are the mainstay therapeutic options for prevention of skeletal-related events and generally used for up to 2 years in bone metastatic cancer patients. ⋯ Bisphosphonates might be prolonged for more than 2 years in BMBC patients with an acceptable toxicity profile. In addition, bisphosphonates switch therapy should be preferred in those with progressive bone metastasis since it might contribute to better survival despite bisphosphonates could not have been shown to have survival benefit in previous studies.
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Assess the association between the Society for Vascular Surgery/American Association for Vascular Surgery (SVS/AVSS) (Rutherford et al., J Vasc Surg 26: 517-38, 1997; Chaikof et al., J Vasc Surg 35:1061-6, 2002) medical comorbidity scoring scheme (MCS), and the global scoring system (GS) and major morbidity and mortality after elective endovascular aneurysm repair. Primary end points were peri-operative morbidity and mortality. Secondary end points were intensive care unit admission, high dependency unit admission, total stay > 5 days and 2-year mortality. ⋯ The MCS shows association with perioperative morbidity and mortality. GS shows association with perioperative morbidity but not perioperative mortality; however, this may be due to our study being underpowered. We believe that the analysis of higher numbers of patients could unmask trends in both of these scores and individual components of both scores changed.