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  1 / 64556 MEDLINE  
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[PMID]:29472192
[Au] Autor:Powers JH; Evans SR; Kesselheim AS
[Ad] Endereço:George Washington University School of Medicine, Washington, DC, USA.
[Ti] Título:Studying new antibiotics for multidrug resistant infections: are today's patients paying for unproved future benefits?
[So] Source:BMJ;360:k587, 2018 02 22.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Bacterianas/tratamento farmacológico
Farmacorresistência Bacteriana Múltipla
[Mh] Termos MeSH secundário: Aprovação de Drogas
Previsões
Seres Humanos
Estados Unidos
United States Food and Drug Administration
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180224
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k587


  2 / 64556 MEDLINE  
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[PMID]:29424453
[Au] Autor:Esenboga S; Cagdas D; Ozgur TT; Gur Cetinkaya P; Turkdemir LM; Sanal O; VanDerBurg M; Tezcan I
[Ad] Endereço:Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
[Ti] Título:Clinical and genetic features of the patients with X-Linked agammaglobulinemia from Turkey: Single-centre experience.
[So] Source:Scand J Immunol;87(3), 2018 Mar.
[Is] ISSN:1365-3083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:X-linked agammaglobulinemia is a primary immunodeficiency disorder resulting from BTK gene mutations. There are many studies in the literature suggesting contradictory ideas about phenotype-genotype correlation. The aim of this study was to identify the mutations and clinical findings of patients with XLA in Turkey, to determine long-term complications related to the disease and to analyse the phenotype-genotype correlation. Thirty-two patients with XLA diagnosed between 1985 and 2016 in Pediatric Immunology Department of Hacettepe University Ihsan Dogramaci Children's Hospital were investigated. A clinical survey including clinical features of the patients was completed, and thirty-two patients from 26 different families were included in the study. Getting early diagnosis and regular assessment with imaging techniques seem to be the most important issues for improving the health status of the patients with XLA. Early molecular analysis gives chance for definitive diagnosis and genetic counselling, but not for predicting the clinical severity and prognosis.
[Mh] Termos MeSH primário: Agamaglobulinemia/diagnóstico
Agamaglobulinemia/genética
Anticorpos/sangue
Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico
Doenças Genéticas Ligadas ao Cromossomo X/genética
Proteínas Tirosina Quinases/genética
[Mh] Termos MeSH secundário: Adolescente
Adulto
Agamaglobulinemia/patologia
Infecções Bacterianas/imunologia
Criança
Pré-Escolar
Doenças Genéticas Ligadas ao Cromossomo X/patologia
Seres Humanos
Imunoglobulina A/sangue
Imunoglobulina G/sangue
Imunoglobulina M/sangue
Lactente
Estudos Retrospectivos
Turquia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies); 0 (Immunoglobulin A); 0 (Immunoglobulin G); 0 (Immunoglobulin M); EC 2.7.10.1 (Agammaglobulinaemia tyrosine kinase); EC 2.7.10.1 (Protein-Tyrosine Kinases)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.1111/sji.12647


  3 / 64556 MEDLINE  
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[PMID]:28452704
[Au] Autor:Yan CH; Hahn S; McMahon D; Bonislawski D; Kennedy DW; Adappa ND; Palmer JN; Jiang P; Lee RJ; Cohen NA
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Division of Rhinology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
[Ti] Título:Nitric oxide production is stimulated by bitter taste receptors ubiquitously expressed in the sinonasal cavity.
[So] Source:Am J Rhinol Allergy;31(2):85-92, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bitter taste receptors (T2R) have recently been demonstrated to contribute to sinonasal innate immunity. One T2R, T2R38, regulates mucosal defense against gram-negative organisms through nitric oxide (NO) production, which enhances mucociliary clearance and directly kills bacteria. To determine whether additional T2Rs contribute to this innate defense, we evaluated two other sinonasal T2Rs (T2R4 and T2R16) for regulation of NO production and expression within the human sinonasal cavity. METHODS: Primary human sinonasal cultures were stimulated with ligands specific to T2R4 and T2R16, colchicine and D-salicin, respectively. Cellular NO production was measured by intracellular 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate fluorescence. For T2R expression mapping, sinonasal tissue was obtained from patients who underwent sinus surgery of the middle turbinate, maxillary sinus, ethmoid sinus, or sphenoid sinus. The expression of T2R4, T2R16, and T2R38 was evaluated by using immunofluorescence with validated antibodies. RESULTS: Similar to T2R38, T2R4 and T2R16 trigger NO production in a dose-dependent manner by using the canonical taste signaling pathway in response to stimulation with their respective ligands. All three receptors were expressed in the cilia of human epithelial cells of all regions in the sinonasal cavity. CONCLUSION: These three T2Rs signaled through the same NO-mediated antimicrobial pathway and were ubiquitously expressed in the sinonasal epithelium. Additional T2Rs besides T2R38 may play a role in sinonasal immune defense. Mapping of T2R expression demonstrated the potential widespread role of T2Rs in sinonasal defense, whereas the genetics of these T2Rs may contribute to our understanding of specific endotypes of chronic rhinosinusitis and develop into novel therapeutic targets.
[Mh] Termos MeSH primário: Infecções Bacterianas/imunologia
Mucosa Nasal/imunologia
Seios Paranasais/metabolismo
Receptores Acoplados a Proteínas-G/metabolismo
Rinite/imunologia
Sinusite/imunologia
Paladar
[Mh] Termos MeSH secundário: Bacteriólise
Células Cultivadas
Doença Crônica
Seres Humanos
Imunidade Inata
Depuração Mucociliar
Mucosa Nasal/microbiologia
Óxido Nítrico/metabolismo
Cultura Primária de Células
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptors, G-Protein-Coupled); 0 (taste receptors, type 2); 31C4KY9ESH (Nitric Oxide)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4424


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[PMID]:29458687
[Au] Autor:Tracz DM; Tober AD; Antonation KS; Corbett CR
[Ad] Endereço:1​National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, R3E 3R2, Canada.
[Ti] Título:MALDI-TOF mass spectrometry and high-consequence bacteria: safety and stability of biothreat bacterial sample testing in clinical diagnostic laboratories.
[So] Source:J Med Microbiol;67(3):341-346, 2018 Mar.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We considered the application of MALDI-TOF mass spectrometry for BSL-3 bacterial diagnostics, with a focus on the biosafety of live-culture direct-colony testing and the stability of stored extracts. Biosafety level 2 (BSL-2) bacterial species were used as surrogates for BSL-3 high-consequence pathogens in all live-culture MALDI-TOF experiments. Viable BSL-2 bacteria were isolated from MALDI-TOF mass spectrometry target plates after 'direct-colony' and 'on-plate' extraction testing, suggesting that the matrix chemicals alone cannot be considered sufficient to inactivate bacterial culture and spores in all samples. Sampling of the instrument interior after direct-colony analysis did not recover viable organisms, suggesting that any potential risks to the laboratory technician are associated with preparation of the MALDI-TOF target plate before or after testing. Secondly, a long-term stability study (3 years) of stored MALDI-TOF extracts showed that match scores can decrease below the threshold for reliable species identification (<1.7), which has implications for proficiency test panel item storage and distribution.
[Mh] Termos MeSH primário: Infecções Bacterianas/diagnóstico
Técnicas Bacteriológicas
Armas Biológicas
Técnicas de Laboratório Clínico/métodos
Contenção de Riscos Biológicos
Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos
[Mh] Termos MeSH secundário: Bactérias/isolamento & purificação
Infecções Bacterianas/microbiologia
Técnicas Bacteriológicas/instrumentação
Técnicas de Laboratório Clínico/instrumentação
Seres Humanos
Manejo de Espécimes/efeitos adversos
Manejo de Espécimes/instrumentação
Manejo de Espécimes/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biological Warfare Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000695


  5 / 64556 MEDLINE  
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[PMID]:29269545
[Ti] Título:Equine disease surveillance: quarterly summary.
[So] Source:Vet Rec;181(25):674-677, 2017 12 23.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Surtos de Doenças/veterinária
Doenças dos Cavalos/epidemiologia
Vigilância de Evento Sentinela/veterinária
[Mh] Termos MeSH secundário: Animais
Infecções Bacterianas/epidemiologia
Infecções Bacterianas/veterinária
Feminino
Cavalos
Masculino
Doenças Parasitárias em Animais/epidemiologia
Reino Unido/epidemiologia
Viroses/epidemiologia
Viroses/veterinária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1136/vr.j5900


  6 / 64556 MEDLINE  
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[PMID]:29267669
[Au] Autor:Pourhajibagher M; Ghorbanzadeh R; Bahador A
[Ad] Endereço:Tehran University of Medical Sciences, Department of Microbiology, School of Medicine, Tehran, Iran.
[Ti] Título:Culture-dependent approaches to explore the prevalence of root canal pathogens from endodontic infections.
[So] Source:Braz Oral Res;31:e108, 2017 Dec 18.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Endodontic infections are considered to be caused by the presence of various microorganisms within the root canal system. Recognition of this microbiota contributes to the successful treatment of infected root canals. This study investigated the microorganisms associated with primary and secondary endodontic infections via culture methods, biochemical tests, and molecular approaches in an Iranian population. Microbial specimens were collected from 36 patients with primary endodontic infection and 14 patients with a history of root canal therapy. Advanced microbiological culture techniques were used to isolate microbiota; subsequently, biochemical tests and 16S ribosomal RNA gene sequencing were performed to identify the microorganisms. Within the total 218 cultivable isolates, Veillonella parvula (20.6%) was found to occur with the highest frequency in primary endodontic infection, followed by Porphyromonas gingivalis (14.1%), and Aggregatibacter actinomycetemcomitans (9.2%). Enterococcus faecalis (36.6%) was the most predominant microorganism in secondary endodontic infections, followed by Candida albicans, Propionibacterium acnes, and V. parvula with frequencies of 20%, 2%, and 2%, respectively. It was concluded that V. parvula and E. faecalis was most frequently found in primary and secondary endodontic infections, respectively.
[Mh] Termos MeSH primário: Bactérias Anaeróbias/isolamento & purificação
Cavidade Pulpar/microbiologia
Doenças da Polpa Dentária/microbiologia
[Mh] Termos MeSH secundário: Adulto
Bactérias Anaeróbias/genética
Infecções Bacterianas/epidemiologia
Infecções Bacterianas/microbiologia
Contagem de Colônia Microbiana
Doenças da Polpa Dentária/epidemiologia
Feminino
Seres Humanos
Irã (Geográfico)/epidemiologia
Masculino
Meia-Idade
Técnicas de Amplificação de Ácido Nucleico
Reação em Cadeia da Polimerase
Prevalência
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


  7 / 64556 MEDLINE  
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[PMID]:28467275
[Au] Autor:Dos Santos PF; Mansur DS
[Ad] Endereço:Departament of Microbiology, Immunology and Parasitology, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina , Santa Catarina, Brazil .
[Ti] Título:Beyond ISGlylation: Functions of Free Intracellular and Extracellular ISG15.
[So] Source:J Interferon Cytokine Res;37(6):246-253, 2017 Jun.
[Is] ISSN:1557-7465
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:ISG15 is a ubiquitin-like type I IFN-stimulated protein of 15 kDa and is one of the most prominently expressed proteins in viral infections. ISG15 is widely known to be involved in a process called ISGylation, where it binds to over 150 targets from a variety of classes of proteins including central immune signaling pathways such as those mediated by NFκB, JNK, and IRF-3. However, ISG15 also exists in a free form that can act intra- or extracellularly. In vitro and in vivo evidences suggest that free ISG15 play different roles in several cellular processes, from cancer and defense against viral infections to activation of immune cells such as lymphocytes, monocytes, and NK cells. This review discusses the roles of free intracellular and secreted ISG15 approaching questions yet to be answered about the mechanism of action of this protein.
[Mh] Termos MeSH primário: Infecções Bacterianas/imunologia
Citocinas/imunologia
Interferon gama/imunologia
Transdução de Sinais/imunologia
Ubiquitinas/imunologia
Viroses/imunologia
[Mh] Termos MeSH secundário: Infecções Bacterianas/genética
Infecções Bacterianas/microbiologia
Citocinas/genética
Regulação da Expressão Gênica
Seres Humanos
Fator Regulador 3 de Interferon/genética
Fator Regulador 3 de Interferon/imunologia
Interferon Tipo I/genética
Interferon Tipo I/imunologia
Interferon gama/genética
Monócitos/imunologia
Monócitos/microbiologia
Monócitos/virologia
Neutrófilos/imunologia
Neutrófilos/microbiologia
Neutrófilos/virologia
Linfócitos T/imunologia
Linfócitos T/microbiologia
Linfócitos T/virologia
Ubiquitinas/genética
Viroses/genética
Viroses/virologia
eIF-2 Quinase/genética
eIF-2 Quinase/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cytokines); 0 (IRF3 protein, human); 0 (Interferon Regulatory Factor-3); 0 (Interferon Type I); 0 (Ubiquitins); 60267-61-0 (ISG15 protein, human); 82115-62-6 (Interferon-gamma); EC 2.7.11.1 (eIF-2 Kinase)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1089/jir.2016.0103


  8 / 64556 MEDLINE  
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[PMID]:28461690
[Au] Autor:Mirzaei MK; Maurice CF
[Ad] Endereço:Department of Microbiology and Immunology, Microbiome Disease and Tolerance Centre, McGill University, 3775 University Street, Montreal, Quebec H3H 2B4, Canada.
[Ti] Título:Ménage à trois in the human gut: interactions between host, bacteria and phages.
[So] Source:Nat Rev Microbiol;15(7):397-408, 2017 07.
[Is] ISSN:1740-1534
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The human gut is host to one of the densest microbial communities known, the gut microbiota, which contains bacteria, archaea, viruses, fungi and other microbial eukaryotes. Bacteriophages in the gut are largely unexplored, despite their potential to regulate bacterial communities and thus human health. In addition to helping us understand gut homeostasis, applying an ecological perspective to the study of bacterial and phage communities in the gut will help us to understand how this microbial system functions. For example, temporal studies of bacteria, phages and host immune cells in the gut during health and disease could provide key information about disease development and inform therapeutic treatments, whereas understanding the regulation of the replication cycles of phages could help harness the gut microbiota to improve disease outcomes. As the most abundant biological entities in our gut, we must consider bacteriophages in our pursuit of personalized medicine.
[Mh] Termos MeSH primário: Bactérias/metabolismo
Bacteriófagos/fisiologia
Microbioma Gastrointestinal
Interações Microbianas
[Mh] Termos MeSH secundário: Bactérias/classificação
Bactérias/virologia
Infecções Bacterianas/terapia
Seres Humanos
Medicina de Precisão/métodos
Vírus/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1038/nrmicro.2017.30


  9 / 64556 MEDLINE  
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[PMID]:29355906
[Au] Autor:Vermeij JD; Westendorp WF; Dippel DW; van de Beek D; Nederkoorn PJ
[Ad] Endereço:Department of Neurology, Academic Medical Centre, University of Amsterdam, PO Box 22660, Amsterdam, Netherlands, 1100 DD.
[Ti] Título:Antibiotic therapy for preventing infections in people with acute stroke.
[So] Source:Cochrane Database Syst Rev;1:CD008530, 2018 01 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this Cochrane Review, published in 2012, we found that antibiotics did reduce the risk of infection but did not reduce the number of dependent or deceased patients. However, included studies were small and heterogeneous. In 2015, two large clinical trials were published, warranting an update of this Review. OBJECTIVES: To assess the effectiveness and safety of preventive antibiotic therapy in people with ischaemic or haemorrhagic stroke. We wished to determine whether preventive antibiotic therapy in people with acute stroke:• reduces the risk of a poor functional outcome (dependency and/or death) at follow-up;• reduces the occurrence of infections in the acute phase of stroke;• reduces the occurrence of elevated body temperature (temperature ≥ 38° C) in the acute phase of stroke;• reduces length of hospital stay; or• leads to an increased rate of serious adverse events, such as anaphylactic shock, skin rash, or colonisation with antibiotic-resistant micro-organisms. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (25 June 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5; 25 June 2017) in the Cochrane Library; MEDLINE Ovid (1950 to 11 May 2017), and Embase Ovid (1980 to 11 May 2017). In an effort to identify further published, unpublished, and ongoing trials, we searched trials and research registers, scanned reference lists, and contacted trial authors, colleagues, and researchers in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) of preventive antibiotic therapy versus control (placebo or open control) in people with acute ischaemic or haemorrhagic stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently selected articles and extracted data; we discussed and resolved discrepancies at a consensus meeting with a third review author. We contacted study authors to obtain missing data when required. An independent review author assessed risk of bias using the Cochrane 'Risk of bias' tool. We calculated risk ratios (RRs) for dichotomous outcomes, assessed heterogeneity amongst included studies, and performed subgroup analyses on study quality. MAIN RESULTS: We included eight studies involving 4488 participants. Regarding quality of evidence, trials showed differences in study population, study design, type of antibiotic, and definition of infection; however, primary outcomes among the included studies were consistent. Mortality rate in the preventive antibiotic group was not significantly different from that in the control group (373/2208 (17%) vs 360/2214 (16%); RR 1.03, 95% confidence interval (CI) 0.87 to 1.21; high-quality evidence). The number of participants with a poor functional outcome (death or dependency) in the preventive antibiotic therapy group was also not significantly different from that in the control group (1158/2168 (53%) vs 1182/2164 (55%); RR 0.99, 95% CI 0.89 to 1.10; moderate-quality evidence). However, preventive antibiotic therapy did significantly reduce the incidence of 'overall' infections in participants with acute stroke from 26% to 19% (408/2161 (19%) vs 558/2156 (26%); RR 0.71, 95% CI 0.58 to 0.88; high-quality evidence). This finding was highly significant for urinary tract infections (81/2131 (4%) vs 204/2126 (10%); RR 0.40, 95% CI 0.32 to 0.51; high-quality evidence), whereas no preventive effect for pneumonia was found (222/2131 (10%) vs 235/2126 (11%); RR 0.95, 95% CI 0.80 to 1.13; high-quality evidence). No major side effects of preventive antibiotic therapy were reported. Only two studies qualitatively assessed the occurrence of elevated body temperature; therefore, these results could not be pooled. Only one study reported length of hospital stay. AUTHORS' CONCLUSIONS: Preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of 'overall' infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Bacterianas/prevenção & controle
Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Antibioticoprofilaxia/métodos
Infecções Bacterianas/mortalidade
Isquemia Encefálica/complicações
Seres Humanos
Pneumonia/epidemiologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/mortalidade
Infecções Urinárias/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180123
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008530.pub3


  10 / 64556 MEDLINE  
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[PMID]:29406040
[Au] Autor:Zhao H; Shi Y; Dong H; Hu J; Zhang X; Yang M; Fan J; Ma W; Sheng J; Li L
[Ad] Endereço:State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
[Ti] Título:Community- or Healthcare-Associated Bacterial Infections Increase Long-Term Mortality in Patients With Acute Decompensation of Cirrhosis.
[So] Source:Am J Med Sci;355(2):132-139, 2018 02.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of the present study was to determine the specific role of different types of bacterial infections (BIs) on the prognosis of cirrhotic patients with acute decompensation (AD). METHODS: We performed a prospective, observational cohort study consisting of 492 cirrhotic patients with AD at our center from February 2014 to March 2015. Clinical, laboratory and survival data were collected. The relationship between BIs and mortality was analyzed. RESULTS: BIs were identified in 157 of 492 patients at the time of admission or during the hospital stay. Among the patients, 65 had community-acquired (CA) or healthcare-associated (HCA) BIs, 54 developed hospital-acquired (HA) BIs, and 38 had CA/HCA with HA BIs. Patients with CA/HCA BIs had higher 90-day, 1-year and 2-year mortality rates (29.2%, 44.6% and 52.3%, respectively) and CA/HCA BIs remained an independent risk factor for long-term mortality on multivariate analysis (1 year: hazard ratio = 1.60; 95% CI: 1.07-2.41; P = 0.023 and 2 year: hazard ratio = 1.54; 95% CI: 1.05-2.25; P = 0.026). In contrast, patients with HA BIs had a higher 28-day mortality rate than patients with CA/HCA BIs. Logistic regression analysis showed previous ascites and prior BIs within 3 months were independent risk factors for CA/HCA BIs, whereas invasive minor surgical procedures with acute-on-chronic liver failure throughout the hospital stay and high chronic liver failure-sequential organ failure assessment scores were associated with nosocomial BIs. CONCLUSIONS: CA/HCA BIs were associated with increased long-term mortality in cirrhotic patients with AD, whereas nosocomial BIs may be related to poor short-term prognosis.
[Mh] Termos MeSH primário: Infecções Bacterianas/mortalidade
Doenças Transmissíveis/mortalidade
Mortalidade Hospitalar
Cirrose Hepática/mortalidade
Falência Hepática Aguda/mortalidade
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Idoso
Infecções Bacterianas/etiologia
Infecções Bacterianas/terapia
Doenças Transmissíveis/etiologia
Doenças Transmissíveis/terapia
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Doença Iatrogênica
Tempo de Internação
Cirrose Hepática/complicações
Cirrose Hepática/terapia
Falência Hepática Aguda/terapia
Masculino
Meia-Idade
Fatores de Risco
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE



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