Presse Med
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Comparative Study
[Impact on morbidity and costs of methicillin-resistant Staphylococcus aureus nosocomial pneumonia in intensive care patients].
Prevention of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections in the intensive care units (ICU) has been recommended for several years. However, the workload and the costs of these programs are to be weighed against the benefit obtained in terms of reduction of morbidity and costs induced by the infection. The purpose of this study was to evaluate the cost and the current morbidity of the infection with MRSA in the ICU. ⋯ In the ICU having set up a policy intended to reduce the risk of MRSA nosocomial infections, MRSA pneumonia does not seem to involve major additional morbidity, as compared to a control population matched for similar severity of illness. It increases modestly the use of the medical resources.
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Although peripheral venous catheter (PVC) placement is one of the most common invasive procedures used in hospitals, data about the infectious risk associated with it are sparse. Nurses and physicians often underestimate this risk. We describe here a 10-year continuous quality improvement program in a large university hospital. ⋯ This prolonged multifaceted program, including practice audits, continued medical education and monitoring of PVC-related infection, has led to a substantial decrease over time in the infectious risk related to PVC placement.
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Clinically non-functioning pituitary adenomas and gonadotroph-cell adenomas are relatively common: microadenomas (< 1cm) are usually pituitary incidentalomas while most macroadenomas are revealed by mass effect and/or hypopituitarism. They are rarely associated with high gonadotropin (Luteinizing hormone, LH; Follicle-stimulating hormone FSH) levels while increased alpha-subunit levels are more frequent. ⋯ Treatment of macroadenoma with visual field defect or hypopituitarism is transphenoidal surgery, but cure is rarely obtained and tumor recurrence is significant during follow-up. Therefore postoperative treatment (pituitary radiotherapy or medical treatment with dopamine agonists or somatostatin analogs) should be discussed against close follow-up with repeated MRI scans.