A Review of Common Methods Used to Exclude Infection in Patients with Lower Urinary Tract Symptoms by Kiren Gill in Experimental Techniques in Urology & Nephrology
WHO Italian CME course an antibiotic stewardship
• Understand the frequent occurrence and implications of
contaminated urine cultures and of asymptomatic bacteriuria
• Illustrate the complexity of using urinalysis and urine culture to
support the diagnosis of urinary tract infections
• Demonstrate the use of local evidence-based guidelines based
upon local antimicrobial resistance data in managing urinary tract infections
Asymptomatic urinary tract infection amongst some Students of Michael Okpara ...Premier Publishers
This work was carried out to determine Asymptomatic Urinary Tract Infection amongst some students of Michael Okpara University of Agriculture, Umudike and the sensitivity pattern of the isolates from urine. Using aseptic technique, midstream urine were collected from sixty (60) students, urinalysis was carried out on the urine samples and was then cultured on CLED and MacConkey agar using pour plate method. Growth was observed in 26 (87%) of the sample while there was no growth in 4 (13%) of the sample. Out of the 26 (87%) samples with growth, 14 (47%) had significant bacteria growth while 12 (40%) had no significant growth. Incidence of asymptomatic bacteriuria was higher in females 8 (57%) than males 6 (38%). The organisms isolated were Escherichia coli, Klebsiella species, Staphylococcus saprophyticus, Staphylococcus aureus, Enterococcus faecalis, Proteus species, and Pseudomonas aeruginosa. All the Gram positive isolates were sensitive to Gentamycin and all resistance to Cefuroxime, Ceftazidime, Ceftriaxone, Cloxacillin. The Gram negative isolates were mostly sensitive to Nitrofurantoin, Gentamycin and Ofloxacin. Therefore, these drugs could be considered as the first line of drug for the treatment of asymptomatic urinary tract infection.
Prevalence of Urinary Tract Infection among Patients with Diabetes Melitus in...MCMScience
Background: & Objectives: Urinary tract infection is one of the most commonly occurring infections among the patients with diabetes mellitus.
Methods This investigation was based to evaluate the incidence of UTI in patients with DM. Between January, 2013 to November, 1000 diabetic urine samples were collected. All urine samples were processed in the lab following standard laboratory protocol.
Results: A total of 25 UTI organisms were isolated from 361 urine samples collected from the diabetic patients attending the Department of Emergency, University Hospital Center "Mother Theresa” (QSUT) from. The incidence of UTI was recorded to 36.1%. Escherichia coli (54%) was found to be the major cause of UTI. About 5 different types of organisms isolated from the UTI samples were randomly chosen to test against the UTI antibiotics.
Interpretation & Conclusion: The antibiotic susceptibility pattern revealed that ciprofloxacin and nitrofurantoin were most effective to e.coli 79.6%, and 89.4%. These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies and to assist clinicians in the choice of antibiotic therapy to prevent misuse, or overuse of antibiotics.
Key Words: Diabetes mellitus (DM), Urinary Tract Infection (UTI), Bacteria, antimicrobial resistance
First Urinary Tract Infection Episode in Children: Are Procalcitonin Values & US Examination of Importance in the Diagnosis of Upper Urinary Tract Infection ?
Acute cholecystitis:Severity assessment and managementKETAN VAGHOLKAR
Acute cholecystitis is one of the commonest biliary tract emergency. Early diagnosis and prompt treatment is essential to reduce the morbidity and mortality associated with the disease. Assessment of the severity of the disease is essential to develop a safe therapeutic plan for the patient. The Tokyo guidelines (TG 18/TG 13) provides a lucid system for grading the severity of acute cholecystitis. Supportive care, antibiotic therapy followed by early laparoscopic cholecystectomy is the mainstay of treatment. Fitness to undergo surgery is determined by the Charlson Comorbidity Index and the American College of Anaesthesiologist’s physical status examination. Those unfit for surgery are best treated by early biliary drainage followed by delayed cholecystectomy. The incidence of iatrogenic bile duct injury is high in severe cases. A low threshold for conversion to open cholecystectomy is essential in such cases to prevent iatrogenic biliovascular injuries. A holistic clinical approach comprising of establishing the diagnosis, grading the severity of acute cholecystitis, assessment of fitness to undergo surgery, administration of supportive care and antibiotics followed by early cholecystectomy constitutes a safe surgical approach to acute cholecystitis.
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu ...Premier Publishers
Urinary Tract infections (UTIs) are one of the most common causes of hospital visit worldwide. The study intends to find the prevalence of Escherichia coli in Urinary tract infection cases in Aminu Kano Teaching Hospital (AKTH), Kano. A comprehensive study was conducted on E coli for its prevalence in urine samples, of queried cases of urinary tract infection in patients attending Aminu Kano Teaching Hospital (AKTH), Kano. Two hundred and fourteen urine specimens comprising of 123(57.5%) females and 91(42.5%) males of all age group were screened for bacteria. Of the 214 samples, 68 representing (31.80%) were culture positive with E. coli having 32(47.06%), Klebsiella spp 18(26.47%), Staphylococcus spp 10(14.70%), Proteus spp 6(8.82%) and Pseudomonas spp 2(2.94%). Out of the 32(47.6%) of E. coli isolated, 22 were from female and 10 were from males, the highest prevalence occurred within the age range of 21-30 with females taking the lead. Antibiogram of the isolated E. coli showed a markedly good sensitivity of ofloxacin (96.87%), nitrofurantoin and nalidixic acid (93.70%), colistin phosphate (90.62%) and gentamicin (68.75%). E. coli showed the least sensitivity to ampicillin (18.75%). The frequency of E. coli obtained suggests its high prevalence. And this can be reduced using Flouroquinolones as exhibited by the susceptibility profile in this study.
WHO Italian CME course an antibiotic stewardship
• Understand the frequent occurrence and implications of
contaminated urine cultures and of asymptomatic bacteriuria
• Illustrate the complexity of using urinalysis and urine culture to
support the diagnosis of urinary tract infections
• Demonstrate the use of local evidence-based guidelines based
upon local antimicrobial resistance data in managing urinary tract infections
Asymptomatic urinary tract infection amongst some Students of Michael Okpara ...Premier Publishers
This work was carried out to determine Asymptomatic Urinary Tract Infection amongst some students of Michael Okpara University of Agriculture, Umudike and the sensitivity pattern of the isolates from urine. Using aseptic technique, midstream urine were collected from sixty (60) students, urinalysis was carried out on the urine samples and was then cultured on CLED and MacConkey agar using pour plate method. Growth was observed in 26 (87%) of the sample while there was no growth in 4 (13%) of the sample. Out of the 26 (87%) samples with growth, 14 (47%) had significant bacteria growth while 12 (40%) had no significant growth. Incidence of asymptomatic bacteriuria was higher in females 8 (57%) than males 6 (38%). The organisms isolated were Escherichia coli, Klebsiella species, Staphylococcus saprophyticus, Staphylococcus aureus, Enterococcus faecalis, Proteus species, and Pseudomonas aeruginosa. All the Gram positive isolates were sensitive to Gentamycin and all resistance to Cefuroxime, Ceftazidime, Ceftriaxone, Cloxacillin. The Gram negative isolates were mostly sensitive to Nitrofurantoin, Gentamycin and Ofloxacin. Therefore, these drugs could be considered as the first line of drug for the treatment of asymptomatic urinary tract infection.
Prevalence of Urinary Tract Infection among Patients with Diabetes Melitus in...MCMScience
Background: & Objectives: Urinary tract infection is one of the most commonly occurring infections among the patients with diabetes mellitus.
Methods This investigation was based to evaluate the incidence of UTI in patients with DM. Between January, 2013 to November, 1000 diabetic urine samples were collected. All urine samples were processed in the lab following standard laboratory protocol.
Results: A total of 25 UTI organisms were isolated from 361 urine samples collected from the diabetic patients attending the Department of Emergency, University Hospital Center "Mother Theresa” (QSUT) from. The incidence of UTI was recorded to 36.1%. Escherichia coli (54%) was found to be the major cause of UTI. About 5 different types of organisms isolated from the UTI samples were randomly chosen to test against the UTI antibiotics.
Interpretation & Conclusion: The antibiotic susceptibility pattern revealed that ciprofloxacin and nitrofurantoin were most effective to e.coli 79.6%, and 89.4%. These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies and to assist clinicians in the choice of antibiotic therapy to prevent misuse, or overuse of antibiotics.
Key Words: Diabetes mellitus (DM), Urinary Tract Infection (UTI), Bacteria, antimicrobial resistance
First Urinary Tract Infection Episode in Children: Are Procalcitonin Values & US Examination of Importance in the Diagnosis of Upper Urinary Tract Infection ?
Acute cholecystitis:Severity assessment and managementKETAN VAGHOLKAR
Acute cholecystitis is one of the commonest biliary tract emergency. Early diagnosis and prompt treatment is essential to reduce the morbidity and mortality associated with the disease. Assessment of the severity of the disease is essential to develop a safe therapeutic plan for the patient. The Tokyo guidelines (TG 18/TG 13) provides a lucid system for grading the severity of acute cholecystitis. Supportive care, antibiotic therapy followed by early laparoscopic cholecystectomy is the mainstay of treatment. Fitness to undergo surgery is determined by the Charlson Comorbidity Index and the American College of Anaesthesiologist’s physical status examination. Those unfit for surgery are best treated by early biliary drainage followed by delayed cholecystectomy. The incidence of iatrogenic bile duct injury is high in severe cases. A low threshold for conversion to open cholecystectomy is essential in such cases to prevent iatrogenic biliovascular injuries. A holistic clinical approach comprising of establishing the diagnosis, grading the severity of acute cholecystitis, assessment of fitness to undergo surgery, administration of supportive care and antibiotics followed by early cholecystectomy constitutes a safe surgical approach to acute cholecystitis.
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu ...Premier Publishers
Urinary Tract infections (UTIs) are one of the most common causes of hospital visit worldwide. The study intends to find the prevalence of Escherichia coli in Urinary tract infection cases in Aminu Kano Teaching Hospital (AKTH), Kano. A comprehensive study was conducted on E coli for its prevalence in urine samples, of queried cases of urinary tract infection in patients attending Aminu Kano Teaching Hospital (AKTH), Kano. Two hundred and fourteen urine specimens comprising of 123(57.5%) females and 91(42.5%) males of all age group were screened for bacteria. Of the 214 samples, 68 representing (31.80%) were culture positive with E. coli having 32(47.06%), Klebsiella spp 18(26.47%), Staphylococcus spp 10(14.70%), Proteus spp 6(8.82%) and Pseudomonas spp 2(2.94%). Out of the 32(47.6%) of E. coli isolated, 22 were from female and 10 were from males, the highest prevalence occurred within the age range of 21-30 with females taking the lead. Antibiogram of the isolated E. coli showed a markedly good sensitivity of ofloxacin (96.87%), nitrofurantoin and nalidixic acid (93.70%), colistin phosphate (90.62%) and gentamicin (68.75%). E. coli showed the least sensitivity to ampicillin (18.75%). The frequency of E. coli obtained suggests its high prevalence. And this can be reduced using Flouroquinolones as exhibited by the susceptibility profile in this study.
Chronic Salmonella typhi carrier state: a precursor to gall bladder cancer KETAN VAGHOLKAR
Typhoid fever is one of the commonest infections of the gastrointestinal tract seen in the Indian subcontinent. Association with gall stones can lead to a chronic carrier state. This is a dangerous situation as it can strongly predispose to the development of carcinoma of the gall bladder which is known to have a very poor prognosis. The pathophysiology of this carcinogenic change and its clinical implications are discussed in this paper.
A poster on the incidence and prevalence of Blastocystis and Dientamoeba in IBS patients and controls. Presented by Laura Rindom Krogsgaard (MD, PhD student) at the United European Gastroenterology Week in Berlin, 2013.
Fecal Transplants for treatment of Clostridium Difficile, Ulcerative Colitis ...hurstm78
A summary of information about Fecal Transplants which are used to treat and effectively cure infections of anti-biotic resistant Clostridium Difficile infections of the large intestine. In addition to helping treat c. diff there have been case studies reporting success for treating Ulcerative Colitis and Crohn's Disease as well. Unfortunately access to this treatment through doctors in the United States is currently limited by FDA restrictions which require doctors to first apply for an Investigational New Drug (IND) permit. This has lead to some patients doing fecal transplants themselves.
The lecture was presented during the 13th annual conference of KLRC held in Alexandria 15 -17 August 2017
The lecture was directed to describe the current situation of H.Pylori infection in middle east ,particularly in Egypt , and to put some spotlights on the current regimens of treatment , and the situation of antibiotic resistance in Egypt and its impact on treatment choice
A B C of URINARY TRACT INFECTION, Dr. Sharda Jain Lifecare Centre Lifecare Centre
Urinary Tract Infection
Overview
Understanding Urinary Tract Infection
How Big is theProblem
What is UTI
Why UTI is more Common in Woman
Pathogenesis
Classification
Risk Factors
Causative Organisms
Clinical Manifestation
Diagnosis
Clinicobacteriological study of Urinary tract infection in pregnant womeniosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Chronic Salmonella typhi carrier state: a precursor to gall bladder cancer KETAN VAGHOLKAR
Typhoid fever is one of the commonest infections of the gastrointestinal tract seen in the Indian subcontinent. Association with gall stones can lead to a chronic carrier state. This is a dangerous situation as it can strongly predispose to the development of carcinoma of the gall bladder which is known to have a very poor prognosis. The pathophysiology of this carcinogenic change and its clinical implications are discussed in this paper.
A poster on the incidence and prevalence of Blastocystis and Dientamoeba in IBS patients and controls. Presented by Laura Rindom Krogsgaard (MD, PhD student) at the United European Gastroenterology Week in Berlin, 2013.
Fecal Transplants for treatment of Clostridium Difficile, Ulcerative Colitis ...hurstm78
A summary of information about Fecal Transplants which are used to treat and effectively cure infections of anti-biotic resistant Clostridium Difficile infections of the large intestine. In addition to helping treat c. diff there have been case studies reporting success for treating Ulcerative Colitis and Crohn's Disease as well. Unfortunately access to this treatment through doctors in the United States is currently limited by FDA restrictions which require doctors to first apply for an Investigational New Drug (IND) permit. This has lead to some patients doing fecal transplants themselves.
The lecture was presented during the 13th annual conference of KLRC held in Alexandria 15 -17 August 2017
The lecture was directed to describe the current situation of H.Pylori infection in middle east ,particularly in Egypt , and to put some spotlights on the current regimens of treatment , and the situation of antibiotic resistance in Egypt and its impact on treatment choice
A B C of URINARY TRACT INFECTION, Dr. Sharda Jain Lifecare Centre Lifecare Centre
Urinary Tract Infection
Overview
Understanding Urinary Tract Infection
How Big is theProblem
What is UTI
Why UTI is more Common in Woman
Pathogenesis
Classification
Risk Factors
Causative Organisms
Clinical Manifestation
Diagnosis
Clinicobacteriological study of Urinary tract infection in pregnant womeniosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Etiology and Antimicrobial Sensitivity Profile of the Microorganism Associate...inventionjournals
This study proposes to meet the most common aetiologic agents in urinary tract infection and the antimicrobial susceptibility pattern. We analyzed all bacteriological examinations of urine recorded in Central Laboratory do Piauí-LACEN situated in the municipality of Teresina-PI of patients seen in December 2013 period through April 2014. It was observed that were filed during the designated period urine, 1647. Of these, 109 were positive cultural examination. Escherichia coli was the most isolated microorganism (71.6%), followed by the genus Klebsiella (14.7%), by Pseudomonas aeruginosa (2.8) and Proteus mirabilis (1.8%). In relation to antimicrobial susceptibility, Escherichia coli and Klebsiella spp feature high resistance to antimicrobials Amoxicillin, Piperacilina, Cephalotin, Ceftazidime and Quinolones. To the Enterobacteria in study, Imipeneme, Netilmicin and Amikacin were the antimicrobials with higher degree of susceptibility. In respect of Pseudomonas aeruginosa isolates, antimicrobials were more effective, the Imipeneme and Amikacin. In this way, the need to periodically reviews the ITU for being a promising environment for bacterial infection and to understand the evolution of antimicrobial susceptibilities, for part of the main etiological agents, over time.
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Bacteriuria in Pregnant and Non Pregnant Women in Benghazi Acomparative StudyIOSRJPBS
Background: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not well known in our community. Objectives: Determine the prevalence and predictors of bacteriuria in women of the Benghazi, Libya as well as the antibiotic sensitivity patterns of bacterial isolates. Methods: Across-sectional study was carried out amongst pregnant and non pregnant women attending many poly clinics in Benghazi. We recruited 120 consenting women (60 pregnant and 60 non pregnant) for the study. Demographic and clinical data were collected using structured questionnaire. Clean catch midstream urine was collected from each participant. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of 105 bacteria per ml of cultured urine. Identification and susceptibility of isolates was performed using API (BioMerieux, France Company) . Results: Significant bacteriuria was found in the urine of 13.3 % (16) of all women with prevalence of 16.7% in pregnant women. Asymptomatic bacteriuria was detected in 8.3 % (10). The most frequent isolates were Staphylococcus aureus(31.2%),Escherichia coli (25%), Staphylococcus saprophyticus (18.9%), and were sensitive to gentamycin (GN) 87.5%, azithromycin (AZM)75%, and the less effective antibiotics were cephalexine (CL) and ampicillin(AMP) Conclusion: Bacteriuria is frequent in women particularly pregnant women suggesting the need for routine screening by urine culture,which would allow early treatment to avoid the complications. In addition, urinary tract infections appears to be multifactorial.
Abdominal Tuberculosis Revisited–A single institutional experience of 72 case...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
New System for Chronic Renal Failure Compensation Based on the Symbiotic Hemofiltration by Yumatov EA* in Experimental Techniques in Urology & Nephrology
Very Early Post-Operative Ureteral Stent Removal in Pediatric Kidney Transplantation by Megan Adams*, Michael Wachs and Jens Goebel in Experimental Techniques in Urology & Nephrology
Urolithiasis: The Importance of the Post-Analytical Biochemical Process in Disease Diagnosis and Prevention by Fernández VG*, Sobrero MS, Brissón CM, Marsili NR, Bonifacino Belzarena R, Bartolomé J, Cuestas VI and Prono Minella P in Experimental Techniques in Urology & Nephrology
Scrotal Steatocystoma Multıplex by Ercüment keskin*, İbrahim karabulut, Fatih Özkaya, Ragıp İsmail Engin, Sevilay Akalp Özmen, Fevzi Bedir and Fatih Kürşat yilmazel in Experimental Techniques in Urology & Nephrology
Effect of Selenium in Treatment of Male Infertility by Mossa M Morbat, Azzawi M Hadi* and Dekhel H Hadri in Experimental Techniques in Urology & Nephrology
"No Anastomosis" Combined Colon Conduit and Colostomy Diversion with Pelvic Exenteration: An Underutilized, Cost-Effective Technique Reducing Bowel Complications by Sayyid KR, Neal DE, Albo D, Kruse EJ, Wallbillich JJ, Rungruang BJ, Ghamande SJ and Martha K Terris* in Experimental Techniques in Urology & Nephrology
Non-Viral Φc31 Integrase Mediated In Vivo Gene Delivery to the Adult Murine Kidney by Daniel C Chung, Matthew C Canver, Xiaofeng Zuo and Jean Bennett and Joshua H Lipschutz* in Experimental Techniques in Urology & Nephrology
Radical Salvage Prostatectomy with Pelvic Lymphadenectomy Extended Post Primary Treatment with Prostate Radiotherapy - Case Report and Literature Review by Daniel Savoldi Juraski, MD; Rodrigo Galves Mesquita Martins, MD; Diogo Eugenio Abreu da Silva, MsC; Tomás Accioly de Souza, MD and José Anacleto Dutra de Resende* in Experimental Techniques in Urology & Nephrology
Application of 3D Modeling for Preoperative Planning and Intra Operative Navigation during Procedures on the Organs of Retroperitoneal Space by Alexey A Rozhentsov in Experimental Techniques in Urology & Nephrology
Cutaneous Metastasis of Transitional Cell Carcinoma of Urinary Bladder-An Unusual Case by Vazir Singh Rathee in Experimental Techniques in Urology & Nephrology
Mid Term Functional Results Following Surgical Treatment of Recto-Urinary Fistulas Post Prostate Cancer Treatment by Pierre Etienne Theveniaud in Experimental Techniques in Urology & Nephrology
Uroflowmetry and Post-Void Urine Volume in the Initial Evaluation of Suspected Obstructive Prostatic Enlargement by Sigiberto II García-Nares in Experimental Techniques in Urology & Nephrology
Hyperoxaluria Induces Oxidative DNA Damage and Results in Renal Tubular Epithelial Cell Apoptosis: A Clue to the Pathogenesis of Urolithiasis by Hasan Aydin in Experimental Techniques in Urology & Nephrology
Loin Pain and Haematuria Syndrome (LPHS) Linked to Symptomatic Nephroptosis (SN) and Revealing Pedicle Stretch Causing Neuro-Ischaemia Using the New IVU 7 Sign by Ahmed N Ghanem in Experimental Techniques in Urology & Nephrology
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
2. Experimental Techniques in Urology & Nephrology
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Exp Tech Urol Nephrol
How to cite this article: Kiren G, Govind D. A Review of Common Methods Used to Exclude Infection in Patients with Lower Urinary Tract Symptoms. Exp Tech
Urol Nephrol. 1(1). ETUN.000505. 2017. DOI: 10.31031/ETUN.2017.01.000505
Volume 1 - Issue - 1
in patients with symptoms of acute cystitis, bacterial growth of
greater than 102
cfu ml-1
of a known urinary pathogen was a more
appropriate threshold in this group of patients [3,9]. Unfortunately
however much of this work has been overlooked and in patients
who present with LUTS, many laboratories still define a positive
culture as growth of more than 105
cfu ml-1
of a known urinary
pathogen.
In clinical medicine, to aid diagnosis we frequently use absolute
terms to describe the existence or absence of disease. However
nature and biology do not allow such distinct entities and commonly
disease manifests across a spectrum [10]. In patients describing
symptoms of acute frequency and dysuria the diagnosis of UTI is
not challenging and should be based on history alone. However in
patients presenting with non-dysuric symptoms we still rely on the
use of current investigations to help exclude urinary infection. It is
now widely appreciated that in patients with lower urinary tract
symptoms, a midstream urine sample that is reported as negative
based on the 105
cfu μl-1
threshold does not exclude significant UTI
[3,8,11-14]. It is also important to consider that nature works does
not present with categories but to consider a continuum.
The work by Kass also only addressed pathogenic coliform
organisms, and mixed growth was thought to be likely due to
contamination and was dismissed. There is now evidence to
support polymicrobial infection in human disease, with work
exploring this in the bladder [4]. The culture methods used today
also assume dominant pathogenicity from the Enterobacteriaceae
species, notably E coli. Because of this assumption, the MSU culture
is performed on a selective medium (selective chromogenic
medium) for Enterobacteriaceae under aerobic conditions. This
does not allow for the growth of anaerobic bacteria and other
pathogens, which do not grow well under such culture conditions.
Whilst this might be appropriate for diagnosing acute infection,
there is no evidence that the same bacteria are implicated in chronic
infections or patients presenting with non-dysuric lower urinary
tract symptoms such as in the overactive bladder. It is therefore not
appropriate to use the current MSU culture for such patients and
this is an avenue that warrants further explorations.
Microscopy of urine for the detection of urinary leucocytes
is widely used as a surrogate marker of urinary infection. Due to
the time, cost and effort of MSU cultures, in some laboratories,
microscopy of pyuria acts as a screening tool where only those
samples with significant microscopic pyuria are then sent for
culture. This technique stems from Dukes work in 1927 which
predates Kass’ work. His work reviewed midstream urine samples
from 300 asymptomatic volunteers and found a mean leucocyte
counts of 1.6wbc μl-1
in males and 5.4wbc μl-1
in females with a
range of 0-50wbc μl-1
[15].
From this, he proposed an arbitrary cut off of <10wbc μl-1
as the limit for normal pyuria. As a consequence we now use a
microscopic pyuria ≥10wbc μl-1
to suggest urinary infection. The
work by Dukes is open to similar criticism to Kass’ work of spectrum
bias. Here a healthy population has been used to define disease in
a symptomatic population. In addition the data from Dukes work
shows a wide range of pyuria and hence the data would be skewed
and not normally distributed. Therefore use of the median would
have been a more appropriate measure of central tendency and
had that occurred, zero pyuria would have been promoted as the
normal state. The samples collected in Dukes’ work were also
voided samples and without careful sampling may be subject to
contamination. Studies comparing catheter sampling do not report
any differences in leucocyte excretion between the sexes.
Microscopic pyuria is commonly used to exclude infection and
many studies have reviewed its performance against quantitative
bacterial culture. Some studies have however found that those with
symptoms of acute UTI were culture negative, against a threshold
of ≥105
cfu ml-1
as diagnostic of infection, nearly half demonstrated
leucocyte excretion of ≥10 wbc μl-1
[16,17]. These data support
pyuria excretion ≤10wbc μl-1
as a common finding amongst women
with acute cystitis symptoms, and questions the microbiological
definition of UTI, long before Kass’ work was re-evaluated. This
history illustrates the error of propositions being accepted as
explanatory in the absence of empirical support.
There are limited data evaluating the role of microscopic pyuria
as a surrogate marker of infection in patients with non-acute
symptoms. In patients with painless LUTS microscopic pyuria has
been reported to have a sensitivity of 56% (95% CI 46-60%) and
specificity of 72% (95% CI 67-76%) for midstream urine (MSU)
cultures at ≥105
cfu ml-1
, and 66% (95% CI 54-77%) and 73%
(95% CI 69-78%) respectively for catheter specimen of urine (CSU)
culture at ≥105
cfu ml-1
[18]. In patients presenting with non-acute
symptoms Kupelian et al. [19] found the positive predictive value
(PPV) and negative predictive valve (NPV) of pyuria as a surrogate
marker of UTI to be 0.40 (CI 0.37-0.43) and 0.75 (CI 0.73-0.76)
respectively. They found that 40% of the inflammatory signal was
lost by 4 hours after sample collection which is a common delay
between patients providing samples and time taken to arrive at
laboratories for analysis [19]. Given that microscopy of urine is
performed by laboratories so that only those with ≥10wbc μl-1
require culture samples may be wrongly dismissed as negative for
infection.
Urinary dipsticks are commonly used in both primary and
secondary care as a bed side test and in point of care testing when
excluding urinary infection. They were introduced as part of ‘point
of care testing’ to aid in diagnosis of UTI and reduce the need for
urine microscopy and urine culture and allow for earlier treatment.
Modern reagent strips are able to provide information on a variety
of physical and biochemical variables. The principle measure of UTI
includes the presence of leucocyte esterase and nitrites. Leucocyte
esterase is a potential measure of pyuria and the Nitrite test uses
the Greiss reaction to detect a nitrate reduction product of some
uropathogenic bacteria [20]. The International Consultation on
Incontinence guidelines on LUTS strongly recommends the need
to exclude UTI and recommends dipstick testing as a screening
method [21]. NICE also recommends the use of urinary dipstick
for screening patients with lower urinary tract symptoms [22].
However, there are no published data to support dipstick as a valid
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Exp Tech Urol NephrolExperimental Techniques in Urology & Nephrology
How to cite this article: Kiren G, Govind D. A Review of Common Methods Used to Exclude Infection in Patients with Lower Urinary Tract Symptoms. Exp Tech
Urol Nephrol. 1(1). ETUN.000505. 2017. DOI: 10.31031/ETUN.2017.01.000505
Volume 1 - Issue - 1
screening tool for patients with non-acute, non-dysuric symptoms.
On reviewing the literature there is considerable evidence to
question the accuracy of urinary dipsticks [5,6,23,24]. The
sensitivity of leucocyte esterase has been suggested to be around
60% and specificity of around 70%. The sensitivity of nitrite is
approximately 18%-50%, with reported specificities of 90% [5,24].
However this is using a gold standard as an MSCU culture with a
positive threshold as ≥105
cfu ml-1
.
In assessing anyone who presents with LUTS a mandatory
step is the exclusion of UTI, but given the deficiencies in the tests
diagnosis may be flawed. We must therefore be aware of this and
take into consideration the potential for infection. This warrants
further research into how we identify and exclude infection, as
well as re-evaluates the pathophysiology of common urological and
urogynaecological conditions.
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