Successful Treatment of Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome with the Addition of Linezolid.

Necrotizing fasciitis is a deep-seated subcutaneous tissue infection that is commonly associated with streptococcal toxic shock syndrome (TSS). Surgical debridement plus penicillin and clindamycin are the current standard of care. We report a case of necrotizing fasciitis and streptococcal TSS where linezolid was added after a failure to improve with standard therapy.

Active zone proteins are transported via distinct mechanisms regulated by Par-1 kinase.

Disruption of synapses underlies a plethora of neurodevelopmental and neurodegenerative disease. Presynaptic specialization called the active zone plays a critical role in the communication with postsynaptic neuron. While the role of many proteins at the active zones in synaptic communication is relatively well studied, very little is known about how these proteins are transported to the synapses.

Ceftaroline for the treatment of methicillin-resistant bacteremia.

Purpose: The utility of ceftaroline for the treatment of methicillin-resistant bacteremia (MRSAB) is reviewed.

Summary: Ceftaroline was originally approved for the treatment of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSIs) but recently received an additional approval for the treatment of bacteremia (SAB) associated with ABSSSIs. Ceftaroline has demonstrated efficacy for the treatment of MRSAB, including isolates with elevated minimum inhibitory concentrations to conventional therapy when used alone or in combination with other agents.

Differential effects of film on preschool children's behaviour dependent on editing pace.

Aim: Evidence on how the pace of television and film editing affects children's behaviour and attention is inconclusive. We examined whether a fast-paced film affected how preschool-aged children interacted with toys.

Methods: The study comprised 70 children (36 girls) aged two to four-and-a-half years who attended preschools in Essex, United Kingdom.

Ceftazidime/Avibactam: Who Says You Can't Teach an Old Drug New Tricks?

Purpose: Gram-negative resistance continues to rise with treatment options becoming more limited. Ceftazidime/avibactam was recently approved in the United States and Europe, which combines an established third-generation cephalosporin with a new, unique, non-β-lactam β-lactamase inhibitor. This review conducts a thorough examination of structure, pharmacology, spectrum of activity, pharmacokinetics/pharmacodynamics, in vitro and clinical efficacy and safety/tolerability of ceftazidime/avibactam, as well as detailed future directions for the agent.

Comparison of susceptibility patterns using commercially available susceptibility testing methods performed on prevalent Candida spp.

The rising rates of invasive fungal infections caused by non-albicans Candida and the increasing emergence of antifungal resistance complicate the management of invasive candidiasis. Accurate and timely antifungal susceptibility testing is critical to targeting antifungal therapy. The purpose of this study was to compare commercially available susceptibility testing methods using prospectively collected Candida isolates.

Tackling student attrition.

The government has no idea why nursing student attrition is rising (analysis, 23 November). There has been little research into why students drop out; what has been found is not just down to finance, but also the pressure of the course.

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application.

The elderly population can be divided into three distinct age groups: 65-74 years (young-old), 75-84 years (middle-old), and 85+ years (old-old). Despite evidence of a shift in leading causes for mortality in the elderly from infectious diseases to chronic conditions, infections are still a serious cause of death in this population. These patients are at increased risk due to weakened immune systems, an increased prevalence of underlying comorbidities, and decreased physiologic reserves to fight infection.

Pronounced heterogeneity observed in high-level daptomycin-resistant viridans group streptococci.

Viridans group streptococci (VGS) have demonstrated high-level daptomycin resistance (HLDR) upon daptomycin exposure. This study evaluated the extent of heterogeneity and whether dose escalation or combination therapy could prevent resistance development. Five VGS strains (daptomycin MICs 0.

Objective Assessment of Checklist Fidelity Using Digital Audio Recording and a Standardized Scoring System Audit.

Objectives: The use of the World Health Organization Surgical Safety Checklist (SSC) has been reported to significantly reduce operative morbidity and mortality rates. Recent findings have cast doubt on the efficacy of such checklists in improving patient safety. The effectiveness of surgical safety checklists cannot be fully measured or understood without an accurate assessment of implementation fidelity, most effectively through direct observations of the checklist process.

Reducing Variability in Orthogonal Reformatted Image Quality Associated With Axial Long-z-Axis CT Angiography.

Objective: The objective of our study was to reduce variation in image quality of orthogonal reformatted images generated from long-z-axis CT angiography (CTA) studies of the upper and lower extremities.

Subjects And Methods: Upper and lower extremity CTA studies were targeted at a single health care system. A correctly performed CTA examination was defined as one that met the following three criteria: Sagittal and coronal reformats were obtained, a high-resolution matrix greater than 512 × 512 was used, and reformatted images were available in a distance-measurable format.

Impact of piperacillin-tazobactam shortage on meropenem use: implications for antimicrobial stewardship programs.

Drug shortages pose a clear detriment to antimicrobial stewardship (AS) efforts. Our objective was to evaluate the effect of a piperacillin-tazobactam shortage on meropenem use, related costs, and associated changes in AS activity. A quasi-experimental quality improvement review compared adult patients receiving meropenem ≥72h three months pre-shortage and three months during the shortage.

Endothelial Cell Inflammatory Reactions Are Altered in the Presence of E-Cigarette Extracts of Variable Nicotine.

Exposure to tobacco smoke has been associated with heightened endothelial cell activities associated with cardiovascular diseases (CVD). Conversely, the exposure to nicotine both activates and inhibits particular endothelial cell functions. However, which constituent(s) of tobacco smoke is responsible for these changes is unknown, since toxic gases and fine particulate matter cannot be isolated.

Analysis of safety outcomes for radial versus femoral access for percutaneous coronary intervention from a large clinical registry.

Objective: Using a multisite, contemporary registry of 58 862 percutaneous coronary intervention (PCI) procedures in a national healthcare system, the present study compared radial access with femoral access on safety and efficacy outcomes.

Methods: This is a real-world, large-scale, retrospective study using clinical data from a 137-hopsital System and reported to a multisite clinical registry. All patients undergoing a cardiac catheterisation procedure were included in this database.

Are Psychiatrists Ready for Health Care Reform? Findings From the Study of Psychiatric Practice Under Health Care Reform.

Objective: This study sought to describe the extent to which psychiatrists, prior to insurance expansions under the Affordable Care Act (ACA), reported currently participating or being likely to participate in integrated services delivery models, to assume new roles, to accept new reimbursement structures, and to use electronic health records (EHRs).

Methods: A cross-sectional probability survey of U.S.

Evaluation of Pharmacodynamic Interactions Between Telavancin and Aztreonam or Piperacillin/Tazobactam Against Pseudomonas aeruginosa, Escherichia coli and Methicillin-Resistant Staphylococcus aureus.

Introduction: In clinical trials comparing telavancin (TLV) with vancomycin for treatment of hospital-acquired pneumonia, TLV demonstrated lower clinical cure rates than vancomycin in patients who had mixed gram-positive and -negative infections and were concomitantly treated with either aztreonam (ATM) or piperacillin/tazobactam (PTZ). Here, we investigated therapeutic interactions between TLV and ATM or PTZ in an in vitro pharmacokinetic/pharmacodynamic (PK/PD) model under simulated reduced renal function conditions.

Methods: In vitro one-compartment PK/PD models were run over 96 h simulating TLV 10 mg/kg every 48 h, ATM 500 mg every 8 h and PTZ continuous infusion 13.

Elbasvir/Grazoprevir: A Review of the Latest Agent in the Fight against Hepatitis C.

Hepatitis C virus (HCV) is estimated to affect up to 150 million people worldwide. Despite worldwide prevalence, treatment modalities prior to 2011 remained suboptimal, with low virologic response rates and intolerable side effect profiles. Fortunately, the landscape of treatment for chronic hepatitis C has rapidly evolved since the introduction of HCV NS3/4 protease inhibitors in 2011.

Daptomycin in Combination with Ceftolozane-Tazobactam or Cefazolin against Daptomycin-Susceptible and -Nonsusceptible Staphylococcus aureus in an In Vitro, Hollow-Fiber Model.

Ceftolozane-tazobactam (TOL-TAZ) is a novel cephalosporin/beta-lactamase inhibitor with activity against several Gram-negative pathogens. Daptomycin (DAP) has demonstrated synergistic activity with beta-lactams against methicillin-resistant Staphylococcus aureus (MRSA) isolates with reduced lipopeptide and glycopeptide susceptibilities. Our objective was to determine if DAP and TOL-TAZ possess synergy in hollow-fiber pharmacokinetic/pharmacodynamic (PK/PD) models.