Frequent antibiotic prescriptions for urinary infections (UI) promote the development and spread of antibiotic resistance. In order to identify effective antibiotics for the first line treatment of UI at the Galaţi Infectious Diseases Hospital, we performed a retrospective study based on disk diffusion antibiotic sensitivity testing on bacterial strains from urine cultures. Urine samples were collected from hospitalized patients admitted with symptomatic UI during 2010. In total, 659 records were found of certified bacteriological UI, of which 82% were caused by Enterobacteriacea. Escherichia coli isolates were the most commonly encountered species of Enterobacteriaceae (83%). The median age of the patients with urinary E. coli was 48 [3; 87], sex ratio M/F= 56/399 and 9.8% of patients were HIV positive. Using the Carmeli scoring system for antibiotic resistance risk, we found that 86% of the E. coli isolates were community acquired infections. High level of resistance was evident for Ampiciline at 85%, Neoxazole at 54,6%, TMP-SMX at 45,6% and AmoxiClavulanate at 40,2%. The best sensitivity was obtained with 3rd generation cephalosporins and carbapenemes. The incidence of ESBL-positive strains was 7.4% (34/421). No ESBLpositive strain was identified in community acquired UI (Carmeli score 1). In conclusion, it is strongly recommended that the first line of antibiotic therapy at the Gala ţi Infectious Diseases Hospital should involve 3rd generation cephalosporins, while carbapenems should be reserved to patients with a Carmeli score of 2 or 3.
Nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels present in many regions of the central nervous system (CNS) and the peripheral nervous system. The neuronal nicotinic acetylcholine receptors, being situated at the level of different neurotransmission pathways, participate in the function of many cerebral activities.Consequently, qualitative or quantitative deficits of nicotinic receptors are responsible for dysfunctions of these brain activities; such dysfunctions can occur at different stages of life due to brain aging or numerous neurological and psychiatric diseases of the developmental age, adulthood and old age. Modifications of specific nAChR subtypes have been found localized in specific brain regions in each such disorder.In this review, we will discuss some of the above-mentioned brain disorders, reporting the relevant nAChR changes discovered to date, and summarize the therapeutic prospects currently under development.
Palliative procedures are those usually used in the treatment of metastatic limb sarcoma. However given the impressive results obtained with hyperthermic isolated limb perfusion (ILP), we tested the feasibility of isolated lung perfusion (ILuP), using the same regimen. Three patients with multiple metastases from limb sarcoma were included in this study.ILP was applied in one patient resulting in limb preservation. Patients underwent 90minute ILuP, and subsequent metastasectomy. In all cases the procedure was completed without complications. No systemic toxicity developed. The only postoperative complication was one case of reversible interstitial and alveolar lung edema. The three patients are still alive and two of them were disease-free at a mean follow-up of 19 months. ILuP, with TNF and Melphaln, proved to be feasible and safe. This technique, in association with ILP, might improve long-term survival and quality of life in patients with multiple metastases from limb sarcoma.
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