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Treat the Patient as a Whole, Not Just the Laboratory Findings: A Case of Contaminated Blood Cultures With Subsequent Iatrogenic Complications.
Cureus
October 2024
Neurological Surgery, Paul Kaloostian M.D. Inc., Pasadena, USA.
Sepsis is a serious condition involving life-threatening infection-driven immune response and organ dysfunction. In the emergency department (ED), patients at high risk for sepsis or those with suspected sepsis are managed with a standardized protocol which includes empiric broad-spectrum antibiotic therapy pending blood culture results and susceptibilities, if applicable. While the benefits generally outweigh the risks, this approach may lead to complications, including allergic reactions, gastrointestinal irritation, acute kidney injury, and even financial toxicity, particularly in cases of contaminated blood cultures.
View Article and Find Full Text PDFPersonalized azithromycin treatment rules for children with watery diarrhea using machine learning.
medRxiv
October 2024
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Introduction: We used machine learning to identify novel strategies to target azithromycin to the children with watery diarrhea who are most likely to benefit.
Methods: Using data from a randomized trial of azithromycin for watery diarrhea, we developed personalized treatment rules given sets of diagnostic, child, and clinical characteristics, employing a robust ensemble machine learning-based procedure. For each rule, we estimated the proportion treated under the rule and the average benefits of treatment.
Macrolide resistance is pervasive in oral streptococci in the Belgian general population: a cross-sectional survey.
J Med Microbiol
November 2024
Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
Commensal streptococci are common inhabitants of the oral microbiome and regulate its structure and function in beneficial ways for human health. They can, however, also be opportunistic pathogens and act as a reservoir of resistance genes that can be passed on to other bacteria, including pathogens. Little is known about the prevalence of these commensals in parents and their children and their antimicrobial susceptibilities in the Belgian general population.
View Article and Find Full Text PDFVitamin C, doxycycline, and azithromycin (VDA) targeted changes in cellular senescence-related genes in human adipose-derived mesenchymal stem cells.
Iran J Basic Med Sci
January 2024
Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Article Synopsis
- - The study focuses on adipose-derived mesenchymal stem cells (ASCs) and how the combination of vitamin C, doxycycline, and azithromycin affects genes related to cellular senescence, which is important for their potential therapeutic uses.
- - After treating human ASCs with the drugs, it was found that vitamin C significantly reduced p21 gene expression, suggesting it aids cell cycle progression, while doxycycline and azithromycin increased p21 expression and influenced cell cycle phases.
- - The combination treatment of all three drugs indicated complex interactions that could enhance research into reducing senescence in ASCs, highlighting a promising avenue for future therapeutic strategies.
Incidence, antimicrobial susceptibility & out of pocket expenditure of severe enteric fever in Chandigarh, north India.
Indian J Med Res
June 2024
Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Article Synopsis
- The study aimed to estimate the burden of enteric fever in Chandigarh, India, to inform vaccine policy decisions, focusing on incidence rates, antimicrobial susceptibility, and out-of-pocket expenses (OOPE) for affected individuals.
- Data was collected from May 2018 to March 2020 through a hybrid surveillance system, finding an incidence of enteric fever at 226.8 cases per 100,000 person-years and highlighting significant hospital costs related to the disease.
- Results showed high susceptibility of Salmonella to most antibiotics except for ciprofloxacin, with higher OOPE for patients hospitalized longer and those infected with S. Paratyphi compared to S. Typhi.
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