Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 2006
Endocarditis at a tertiary hospital: reduced acute mortality but poor long term prognosis.
The outcome in 132 patients with infective endocarditis diagnosed in accordance with the Duke criteria at a tertiary hospital in Denmark in the period 1998-2000 is reported. The total in-hospital mortality was 15%. Indications are that in-hospital mortality over the last decade has been reduced by around a quarter. ⋯ It is concluded that surgery may be associated with lower short- and intermediate-term mortality, while the effect might decline in the long-term. High age, prosthetic valve endocarditis, and Staphylococcus aureus endocarditis were independent predictors for high mortality. Although improvements have occurred over recent years, infective endocarditis is still a high mortality disease.
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Scand. J. Infect. Dis. · Jan 2006
Genotypic analysis of Acinetobacter bloodstream infection isolates in a Turkish university hospital.
Acinetobacter baumannii is a significant pathogen of bloodstream infections in hospital patients that frequently causes single clone outbreaks. We aimed to evaluate the genetic relatedness and antimicrobial susceptibility of Acinetobacter spp. bloodstream isolates, in order to obtain insight into their cross-transmission. This prospective study was conducted at the Erciyes University Hospital. ⋯ All Acinetobacter isolates were multidrug-resistant and the crude mortality of patients infected with A. baumanii was 80.5%. We concluded that the genetic relatedness of Acinetobacter spp. causing BSI was very high, indicating cross-transmission within the ICU setting. Essential components of an infection control programme to prevent nosocomial transmission of A. baumannii are early detection of colonized patients, followed by strict attention to standard precautions and contact isolation.
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Syphilis is a sexually transmitted disease caused by Treponema pallidum. Epidemiological studies show that rates have increased dramatically in recent y, especially in human immunodeficiency virus (HIV)-seropositive patients. Although lesions most frequently develop on the genital area, they are presently frequently detected in the oral cavity. ⋯ Following serological tests, clinical symptoms and histopathological findings, lesions were diagnosed as secondary syphilis. A spectacular improvement was achieved with specific treatment. To our knowledge this is the first case described in the literature of secondary syphilis presenting as nodular, painless lesions on the lingual mucosa.
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Most treatment recommendations for acute otitis media favour active use of pain relief medication. These data comprised 3059 Finnish primary care acute otitis media patients. We found that 10.4% of the patients were prescribed or recommended analgesics, which is in contrast to treatment recommendations.
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Scand. J. Infect. Dis. · Jan 2006
Matrix-metalloproteinases and their inhibitors are elevated in severe sepsis: prognostic value of TIMP-1 in severe sepsis.
The enzyme group of matrix metalloproteinases (MMPs) and their inhibitors, so-called tissue inhibitors of matrix-metalloproteinases (TIMPs), are crucial mediators responsible for wound repair after parenchymal damage. Little is known about the role of MMPs and TIMPs in severe sepsis. The aim of the present study was therefore to investigate their levels in patients with severe sepsis and to examine their association with prognosis. ⋯ Septic patients with TIMP-1 values >3200 ng/ml were 4.5 times more likely to die than patients with lower values (RR = 4.5; 95% CI 1.14-17.6, p = 0.014). Our results indicate that MMP-9, TIMP-2 and TIMP-1 are elevated in severe sepsis. Furthermore, TIMP-1 may serve as a useful laboratory marker to predict the clinical outcome of patients presenting with severe sepsis.