Postgraduate medicine
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Postgraduate medicine · Apr 2020
ReviewTreatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents.
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited treatment options. Knowledge of the common uropathogens in addition to local susceptibility patterns is essential in determining appropriate empiric antibiotic therapy of UTIs. The recommended first-line empiric antibiotic therapy for acute uncomplicated bacterial cystitis in otherwise healthy adult nonpregnant females is a 5-day course of nitrofurantoin, a 3-g single dose of fosfomycin tromethamine, or a 5-day course of pivmecillinam. ⋯ Ceftazidime-avibactam, meropenem/vaborbactam, imipenem/cilastatin-relebactam, colistin, fosfomycin, aztreonam and ceftazidime-avibactam, aztreonam and amoxicillin-clavulanate, aminoglycosides including plazomicin, cefiderocol, tigecycline are treatment options for UTIs caused by carbapenem-resistant Enterobacteriales (CRE). Treatment options for UTIs caused by multidrug resistant (MDR)-Pseudomonas spp. include fluoroquinolones, ceftazidime, cefepime, piperacillin-tazobactam, carbapenems including imipenem-cilastatin/relebactam, meropenem, and fosfomycin, ceftolozane-tazobactam, ceftazidime-avibactam, aminoglycosides including plazomicin, aztreonam and ceftazidime-avibactam, cefiderocol, and colistin. It is important to use the new antimicrobials wisely for treatment of UTIs caused by MDR-organisms to avoid resistance development.
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Postgraduate medicine · Apr 2020
Randomized Controlled TrialBlood volume and pain perception during finger prick capillary blood sampling: are all safety lancets equal?
This study aimed to assess various types of safety lancets in terms of blood volume and pain perception during capillary blood sampling, a routine finger-puncture procedure for obtaining a small amount of human blood for running various screening and diagnostic tests. ⋯ NCT04001348. (https://clinicaltrials.gov/ct2/show/NCT04001348?term=NCT04001348&draw=2&rank=1).
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Postgraduate medicine · Apr 2020
ReviewDipstick analysis of urine chemistry: benefits and limitations of dry chemistry-based assays.
Urinalysis is a commonly utilized laboratory test, and analysis of urine has been studied and used since ancient times. Urine contains a wide array of metabolites that can provide information regarding the current physiologic state of the body and clinical manifestations of disease. In this review, we discuss the mechanics of the dry chemistry component of the urine dipstick such as the reaction principles underlying various assays and potential effects of collection and storage on results. Additionally, we discuss the benefits and limitations of the urine dipstick as it pertains to its use as a low-cost tool in point-of-care settings and the reasoning for a lack of its use as a broad screening tool.
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Postgraduate medicine · Apr 2020
Prevalence of burnout syndrome in gastroenterologists and endoscopists: results of a national survey in Mexico.
Burnout syndrome (BOS) is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment. It affects doctors, patients and their inter-relationship. There is a lack of data on BOS in Mexico. The main objective of the present study is to evaluate the prevalence of BOS in physician members of the Mexican gastroenterological association (MGA) and Mexican association for gastrointestinal endoscopy (MAGE). ⋯ BOS is a frequent entity in Mexican gastroenterologists and endoscopists. There are potentially modifiable factors associated with BOS.
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Postgraduate medicine · Apr 2020
Admittances characteristics by sepsis in the Spanish internal medicine services between 2005 and 2015: mortality pattern.
Studies in recent years suggest an increase in the incidence of sepsis but a decrease in mortality. The aim of this study is to describe the characteristics of patients discharged after a sepsis episode from Spanish internal medicine services between 2005 and 2015. ⋯ As in other similar studies, we observed an increase in the hospitalizations by sepsis as a diagnosis at discharge during the study period in Internal Medicine services with a simultaneous decrease in mortality. Comorbidity at admission and complications during admittance condition mortality.