Anti-anaerobic antibiotics associated with increased risk of mortality in criticallyillpatients umich
were also enriched among respiratory pathogens in anti-anaerobic treated patients . In murine models, treatment with anti-anaerobic antibiotics increased susceptibility toIn critically ill patients, early treatment with anti-anaerobic antibiotics is associated with increased mortality. Mechanisms may include enrichment of the gut with respiratory pathogens, but increased mortality is incompletely explained by infections alone.
. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of theAll authors have nothing to disclose.
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Effective hemodynamic monitoring - Critical CareHemodynamic monitoring is the centerpiece of patient monitoring in acute care settings. Its effectiveness in terms of improved patient outcomes is difficult to quantify. This review focused on effectiveness of monitoring-linked resuscitation strategies from: (1) process-specific monitoring that allows for non-specific prevention of new onset cardiovascular insufficiency (CVI) in perioperative care. Such goal-directed therapy is associated with decreased perioperative complications and length of stay in high-risk surgery patients. (2) Patient-specific personalized resuscitation approaches for CVI. These approaches including dynamic measures to define volume responsiveness and vasomotor tone, limiting less fluid administration and vasopressor duration, reduced length of care. (3) Hemodynamic monitoring to predict future CVI using machine learning approaches. These approaches presently focus on predicting hypotension. Future clinical trials assessing hemodynamic monitoring need to focus on process-specific monitoring based on modifying therapeutic interventions known to improve patient-centered outcomes.
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Effect of an 18-Month Meditation Training on Regional Brain Volume and Perfusion in Older AdultsThis randomized clinical trial investigates the effects of meditation training on brain integrity in older adults.
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Molnupiravir and nirmatrelvir-ritonavir treatments are effective in reducing mortality among high-risk COVID-19 patientsMolnupiravir and nirmatrelvir-ritonavir treatments are effective in reducing mortality among high-risk COVID-19 patients HKUniversity COVID19 SARSCoV2 Mortality Molnupiravir NirmatrelvirRitonavir
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Gene expression profiling of mucinous ovarian tumors and comparison with upper and lower gastrointestinal tumors identifies markers associated with adverse outcomes.Abstract. Purpose: Advanced stage MOC have poor chemotherapy response and prognosis and lack biomarkers to aid Stage I adjuvant treatment. Differentiating primary mucinous ovarian carcinoma (MOC) from gastrointestinal (GI) metastases to the ovary is also challenging due to phenotypic similarities. Clinicopathological and gene expression data were analysed to identify prognostic and diagnostic features. Experimental Design: Discovery analyses selected 19 genes with prognostic/diagnostic potential. Validation was performed through the Ovarian Tumor Tissue Analysis consortium and GI cancer biobanks comprising 604 patients with MOC (n=333), mucinous borderline ovarian tumors (MBOT, n=151), upper GI (n=65), and lower GI tumors (n=55). Results: Infiltrative pattern of invasion was associated with decreased overall survival (OS) within 2-years from diagnosis, compared with expansile pattern in Stage I MOC (hazard ratio HR 2.77 (1.04-7.41, p=0.042). Increased expression of THBS2 and TAGLN were associated with shorter OS in MOC patients, (HR 1.25 (95% CI 1.04-1.51, p=0.016)) and (1.21 (1.01-1.45, p=0.043)) respectively. ERBB2 (HER2)-amplification or high mRNA expression was evident in 64/243 (26%) of MOCs, but only 8/243 (3%) were also infiltrative (4/39, 10%) or Stage III/IV (4/31, 13%). Conclusions: An infiltrative growth pattern infers poor prognosis within 2-years from diagnosis and may help select Stage I patients for adjuvant therapy. High expression of THBS2 and TAGLN in MOC confer an adverse prognosis and is upregulated in the infiltrative subtype which warrants further investigation. Anti-HER2 therapy should be investigated in a subset of patients. MOC samples clustered with upper GI, yet markers to differentiate these entities remain elusive, suggesting similar underlying biology and shared treatment strategies.
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