Mayo Clinic proceedings
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Mayo Clinic proceedings · Feb 2012
ReviewMechanisms of resistance and clinical relevance of resistance to β-lactams, glycopeptides, and fluoroquinolones.
The widespread use of antibiotics has resulted in a growing problem of antimicrobial resistance in the community and hospital settings. Antimicrobial classes for which resistance has become a major problem include the β-lactams, the glycopeptides, and the fluoroquinolones. In gram-positive bacteria, β-lactam resistance most commonly results from expression of intrinsic low-affinity penicillin-binding proteins. ⋯ Fluoroquinolone resistance in community-associated strains of Escherichia coli, many of which also express β-lactamases that confer cephalosporin resistance, is increasingly prevalent. Economic and regulatory forces have served to discourage large pharmaceutical companies from developing new antibiotics, suggesting that the antibiotics currently on the market may be all that will be available for the coming decade. As such, it is critical that we devise, test, and implement antimicrobial stewardship strategies that are effective at constraining and, ideally, reducing resistance in human pathogenic bacteria.
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Mayo Clinic proceedings · Feb 2012
Attention-deficit/hyperactivity disorder after early exposure to procedures requiring general anesthesia.
To study the association between exposure to procedures performed under general anesthesia before age 2 years and development of attention-deficit/hyperactivity disorder (ADHD). ⋯ Children repeatedly exposed to procedures requiring general anesthesia before age 2 years are at increased risk for the later development of ADHD even after adjusting for comorbidities.
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To promote wider recognition and further understanding of cannabinoid hyperemesis (CH). ⋯ Cannabinoid hyperemesis should be considered in younger patients with long-term cannabis use and recurrent nausea, vomiting, and abdominal pain. On the basis of our findings in this large series of patients, we propose major and supportive criteria for the diagnosis of CH.
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Mayo Clinic proceedings · Feb 2012
Editorial CommentCannabis--a valuable drug that deserves better treatment.