Medical principles and practice : international journal of the Kuwait University, Health Science Centre
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The objectives of this study were to determine the bacterial profiles and prevalence of antibiotic resistance patterns of bacteria causing bacteremia in febrile children and to compare levels of inflammatory markers between children with and without bacteremia in Kuwait from 2015 to 2022. ⋯ Continuous surveillance of the prevalence and antimicrobial susceptibility patterns of blood isolates is imperative for the formulation of antibiotic policy. WBC, ANC, CRP, and NLR could be valuable indicators of bacteremia in febrile children.
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Atypical femoral fracture (AFF) is an atypical low-energy subtrochanteric and diaphyseal femoral fracture. Even if bone fusion is achieved in patients with AFF, the risk of AFF in the contralateral femur must be considered. This study aimed to investigate the factors affecting complete AFF in the contralateral femur and conservatively treated incomplete AFF. ⋯ Eldecalcitol administration after bone union of first AFF may prevent AFF recurrence. In addition, painful incomplete AFF has a high risk of developing a complete fracture.
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Acinetobacter baumannii (A. baumannii) is an opportunistic bacterium with multiple virulence factors, including capsule and biofilm, and is known for its high drug resistance. Anti-virulence natural substances have been suggested as novel alternatives to conventional antibiotics. We aimed to evaluate the effect of citric and ascorbic acids as anti-biofilm and anti-capsular agents against multidrug-resistant (MDR) A. baumannii clinical isolates. ⋯ Phenotypically, all the isolates were biofilm producers and were capsulated. The MIC of citric acid ranged from 1.25 to 2.5 mg/mL, while that of ascorbic acid was 3 mg/mL for all isolates. Both agents showed significant reduction in biofilm and capsular thinning. Ascorbic acid showed a dose-dependent effect in both biofilm reduction and capsule thinning unlike citric acid. Four genes, papG23, sfa1, fyuA, and cvaC, were absent among all isolates, while iutA was present in 100% of isolates. Other genes showed different distributions among the isolates. These virulence genes were not correlated to the anti-biofilm effect of both agents. Ascorbic acid was observed to have a better effect than citric acid. This can provide a clue for a better treatment regimen including ascorbic acid against MDR A. baumannii infections.
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The incidence of soft tissue sarcomas (STSs) among older patients is increasing. Although surgical treatment of elderly patients with STS has been reported to improve their prognosis, most of these studies included patients with STS aged <85 years. This study aimed to analyze the clinical features and prognostic factors of STS in elderly patients aged ≥90 years. ⋯ In patients with STS aged ≥90 years old, aggressive surgical treatment may improve the prognosis more than radiotherapy.
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The optimal maintenance therapy for rat sarcoma (RAS) and v-raf murine sarcoma viral oncogene homolog B (BRAF) metastatic colorectal cancers (mCRCs) remains unclear. It is critical to evaluate the reliability of cetuximab-capecitabine (the observation group) relative to capecitabine alone (control group). ⋯ Maintenance therapy using cetuximab plus capecitabine improved survival in patients with mCRC and was well tolerated by patients.