Bratisl Med J
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The absence of clinical studies in Slovakia on carbapenem-resistant K. pneumoniae, A. baumannii, and P. aeruginosa, makes planning and treatment strategies challenging and less effective. Our aim is to provide new clinical data on the percentage of healthcare-associated infection, antibiotic resistance profile, and mortality risk associated with these carbapenem-resistant bacteria in our department. ⋯ A. baumannii poses the biggest challenge in the treatment and management of infected patients in our centre in Bratislava. Cephalosporins of the second to fourth generation, quinolones, tetracyclines, and cotrimoxazole are widely ineffective in the treatment of isolated bacteria. Reintroduction of colistin, despite its drug toxicity, can be considered as the last resort treatment I (Tab. 4, Fig. 4, Ref. 30).
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Cerebral microdialysis (CMD) is a method used to measure the concentration of metabolites and glycerol in the interstitium of the brain. The aim of this study was to investigate the effect of parenterally applied medication and nutrition containing external free glycerol (EFG) on cerebral values of glycerol in patients monitored and treated for non-traumatic subarachnoid hemorrhage (SAH). ⋯ The possible effect of externally administered glycerol contained in pharmaceuticals and nutrition on its brain concentrations must be considered when interpreting data of CMD (Tab. 2, Fig. 4,Ref. 16) Keywords: glycerol, microdialysis, brain, subarachnoid hemorrhage.
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Comparative Study
Comparison of inflammation markers with prediction scores in patients with community-acquired pneumonia.
The lymphocyte-to-C-reactive protein ratio (LCRP) and Systemic Immune-Inflammation Index (SII) can successfully predict 28-day mortality rates with community-acquired pneumoniaMETHODS: This prospective study was conducted in 2018. Hospitalized patients underwent follow-up evaluations 28 days after admission. ⋯ A total of 345 patients with CAP were enrolled in this study. All-cause mortality at the 28th day of follow-up was 13.6 %. There were statistically significant results between the 2 groups (survivors and non-survivors), in terms of the LCRP, SII, PSI, and CURB-65 values. Moreover, the optimal LCRP cutoff for predicting 28-day mortality was determined to be 4, with 89 % sensitivity, 73 % specificity. Based on the average SII>3551for predicting 28-day mortality, the sensitivity, specificity was 63.8 %, 68.1 % respectively. When the value of the cutoff PSI was ≥130 points, the sensitivity, specificity was 68 %, 65 %, respectively. Based on 3 points and above as the cutoff value of the CURB-65 score, the sensitivity, specificity was 80 %, 68 %, respectively. ROC curve analysis revealed that the areas of LCRP, SII, PSI, and CURB-65 under the AUC in terms of 28-day mortality were 0,820,0,737,681, and 0,773, respectively,CONCLUSIONS: LCRP and SII level are valuable for predicting the mortality rate among patients with CAP at ED admission (Tab. 3, Fig. 3, Ref. 27).
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Multicenter Study Observational Study
Impact of proactive low-molecular weight heparin therapy on outcomes in COVID-1.
Low molecular weight heparin (LMWH) may provide beneficial effects on outcomes of COVID-19. We aimed to examine the impact of LMWH treatment on clinical outcomes (duration of hospitalization, admission to intensive care unit, the requirement for mechanical ventilation, and death) of COVID-19 patients with normal D-dimer levels at admission. ⋯ Our results strongly suggest that proactive LMWH therapy improves clinical outcomes in hospitalized COVID-19 patients even with normal D-dimer levels (≤ 0.5 mg/L) (Tab. 3, Fig. 2, Ref. 34).
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In addition to the recent success of neprilysin inhibition in treatment of heart failure, elevated soluble neprilysin (sNEP) in circulation has been suggested to be a prognostic biomarker in heart failure with a reduced ejection fraction (HFrEF). However, the diagnostic performance of sNEP is nebulous and its levels in HFrEF have not been compared with controls. For the purpose of this study, we determined the role of sNEP levels as a biomarker in routine ambulatory care of HFrEF patients, when compared to the control subjects. ⋯ Levels of sNEP were significantly reduced in HFrEF, when compared to the controls, with absent correlations to relevant HF-related features (e.g. LVEF). These findings might contribute to clarification of the diagnostic value of sNEP in HF (Tab. 2, Fig. 2, Ref. 30) Keywords: soluble neprilysin, heart failure, reduced ejection fraction, pharmacotherapy.