An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?

Aim: Surgical site infection is commonly caused by Staphylococcus aureus. The multiresistant strains (MRSA) are resistant to most antibiotic prophylaxis regimens. Our aim was to explore whether there is a threshold of MRSA prevalence at which switching to routine glycopeptide-based antibiotic prophylaxis becomes cost-effective.

The impact of trial baseline imbalances should be considered in systematic reviews: a methodological case study.

Objectives: It is possible for baseline imbalances to occur between treatment groups for one or more variables in a randomized controlled trial, although the identification and detection of baseline imbalances remain controversial. If trials with baseline imbalances are combined in a meta-analysis, then this may result in misleading conclusions.

Study Design And Setting: The identification and consequences of baseline imbalances in meta-analyses are discussed.

Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review.

Objectives: To determine the diagnostic accuracy of duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography, alone or in combination, for the assessment of lower limb peripheral arterial disease; to evaluate the impact of these assessment methods on management of patients and outcomes; and to evaluate the evidence regarding attitudes of patients to these technologies and summarise available data on adverse events.

Design: Systematic review.

Methods: Searches of 11 electronic databases (to April 2005), six journals, and reference lists of included papers for relevant studies.

Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial.

Objective: To compare whether differences exist between alternating pressure overlays and alternating pressure mattresses in the development of new pressure ulcers, healing of existing pressure ulcers, and patient acceptability.

Design: Pragmatic, open, multicentre, randomised controlled trial.

Setting: 11 hospitals in six NHS trusts.

Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis.

Objective: To assess the cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital.

Design: Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial.

Setting: 11 hospitals in six UK NHS trusts.

Skin alterations of intact skin and risk factors associated with pressure ulcer development in surgical patients: a cohort study.

Background: The pathology literature suggests three types of pressure ulcer with six possible mechanisms leading to tissue breakdown. A limitation of current evidence is the difficulty in replicating the clinical situation and in determining the point at which a tissue assault becomes irreversible and results in tissue breakdown. In particular clinical observations of alteration in darkly pigmented skin, blanching erythema, non-blanching erythema and non-blanching erythema with other skin changes including induration, oedema, pain, warmth or discolouration have not been assessed in relation to subsequent skin/tissue loss and their pathophysiological and aetiological importance is not fully understood.

Pathology, diagnosis, and classification of pressure ulcers: comparing clinical and imaging techniques.

Pressure ulcer classification systems are based on the clinical manifestations of the skin and tissue layer affected rather than underlying pathology. The objective of this study was to compare the validity of the clinical grading of erythema (blanching and nonblanching) with a measurement of skin perfusion. Therefore, an exploratory study comparing erythema with laser Doppler imaging of the sacrum and buttock skin areas was undertaken.

Assessment of non-ST-segment elevation acute coronary syndromes with cardiac magnetic resonance imaging.

Objectives: The goal of this study was to determine: 1) if the presence of significant coronary stenosis in patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) can be predicted by cardiac magnetic resonance (CMR) imaging; and 2) if the analysis of several CMR methods improves its diagnostic yield compared with analysis of individual methods.

Background: With modern acquisition techniques, several CMR methods for the assessment of coronary artery disease (CAD) can be combined in a single noninvasive scanning session. Such a multicomponent CMR examination has not previously been applied to a large patient population, in particular those with a high prevalence of CAD in an acute situation.