Southern medical journal
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Southern medical journal · Sep 2010
ReviewClostridium difficile: an update for the primary care clinician.
Clostridium difficile infection (CDI) is an important cause of intestinal disease, primarily affecting hospitalized patients exposed to antibiotics. Infection has been associated with prolonged hospital stays and excess healthcare expenditures. Recent changes in the epidemiology, pathogenesis, and treatment of CDI have occurred, leading to renewed scrutiny of this pathogen. ⋯ Furthermore, oral metronidazole may not be as effective as oral vancomycin for patients with severe CDI. New therapies are being investigated for patients with recurrent disease. This review highlights the new developments in the epidemiology, pathogenesis, and management of CDI, serving as an up-to-date resource for primary care clinicians.
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Southern medical journal · Sep 2010
Change in bilirubin level following acute myocardial infarction is an index for heme oxygenase activation.
Heme oxygenase 1 (HO-1) is rapidly induced by stress, degrading pro-oxidant heme into carbon monoxide, bilirubin, and free iron (Fe). Induction of HO-1 is an important defense mechanism against tissue injury. Here, we tested the hypothesis that HO-1 is activated in the myocardium after acute myocardial infarction (AMI) in humans. ⋯ These results suggest that heme oxygenase (HO) was activated following AMI, and it was detectable in the serum. Our data provide the first evidence of HO-1 induction following stress in humans. The change in bilirubin level may be a novel index for high collateral flow formation following AMI.
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Southern medical journal · Sep 2010
Cerebrospinal fluid viscosity: a novel diagnostic measure for acute meningitis.
Early diagnosis of acute meningitis has paramount importance in clinical practice because of mortality and morbidity of the disease. Examination of cerebrospinal fluid (CSF) has critical value for the diagnosis of acute meningitis and discrimination of bacterial and aseptic meningitis. It has been previously reported that plasma viscosity can be used as an inflammatory marker. In this study we aimed to evaluate the role of CSF viscosity as a complementary measure for diagnosis of meningitis in suspected patients. ⋯ The CSF viscosity is a simple and easy method and can be used as an adjunctive measure for the diagnosis of meningitis. With the support of further and larger clinical studies, CSF viscosity may have a role in the discrimination of bacterial versus aseptic meningitis.