Isr Med Assoc J
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The epidemiology of bacteremia with febrile neutropenia: experience from a single center, 1988-2004.
The epidemiology of bacteremic febrile neutropenia differs between locations and constitutes the basis for selection of empiric antibiotic therapy for febrile neutropenia. ⋯ Improved infection-control measures for neutropenic cancer patients in our center are needed. Empiric antibiotic treatment should be tailored to patients' risk for multidrug-resistant organisms. Individual hospitals should monitor infection epidemiology among cancer patients to guide empiric antibiotic treatment.
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Control of postoperative pain after awake craniotomy with local intradermal analgesia and metamizol.
Pain following brain surgery is a significant problem. Infiltration of the scalp with local intradermal anesthetics was suggested for postoperative pain control but was assessed only in the first hour postoperatively. ⋯ Although the clinical setup prevents the use of placebo local analgesia as a control group, the results suggest the possible role of local intradermal infiltration of the scalp combined with a single dose of metamizol to control postoperative pain in patients undergoing craniotomy.
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Unconscious adults with spontaneous circulation after out-of-hospital cardiac arrest should be cooled to 32-34 degrees C (ILCOR recommendations, 2003) when the initial rhythm is ventricular fibrillation. ⋯ MIH, using an external cooling system, is simple and feasible, reduces mortality and protects neurological function. Four major factors seem to influence outcome: age, co-morbidities, duration of hypothermia, and possibly the length of time from collapse to return of spontaneous circulation.
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The use of the bilateral internal mammary arteries has been reserved mainly for younger and low risk patients. ⋯ The performance of mainly arterial revascularization with BIMA grafting in patients 70 years or older is as safe as LIMA grafting, with the added advantage of being a better conduit than saphenous vein graft, requiring fewer blood transfusions, and shorter cardiopulmonary bypass time.