Antibiotherapy is the main determinant of Clostridium difficile infection due to the imbalance determined in the intestinal flora. Clostridium difficile infection can be considered a current public health problem, given the increased incidence, both as a nosocomial infection as well as at community level, by excessive, uncontrolled and unjustified use of antibiotics, high contagiousness, negative influence on health systems in the increased number of days of hospitalization and implicitly increased costs, and last but not least, the substantial deterioration of the quality of the patient�s life. The retrospective study over a 12-month period over a group of 106 patients revealed the following profile of the patient affected by Clostridium difficile infection: females, aged 66.75 � 15.66, from the urban area, hospitalized in the medical section, who had diarrhea more than 2 days after admission, but up to 28 days after this event, due to prolonged antibiotic therapy with ceftriaxone, associated with a gastric secretion inhibitor, on a background of multiple associated pathologies. It is very important for all health systems to control this phenomenon and this is only possible by applying effective measures to prevent the onset of CDI, of relapses and contamination, thus identifying the judicious use of antibiotics.
Diabetic foot is a current public health problem and a late consequence of diabetes. Morbidity and mortality are significant, seriously affecting the patient�s quality of life. Treatment of the diabetic foot is a long-lasting, highly resource-consumption process. Using negative pressure therapy leads to shorter hospitalization periods, better functional outcomes, significantly contributes to decreasing the number of amputations and improving patient�s quality of life. 49 year-old patient is hospitalized with necrotizing at right foot and shank, neglected type II diabetes. It is performed amputation of atypical necessity, right leg, transtarsal, open stump. After successive debridements, negative pressure therapy is installed for a period of 24 days. This favors the formation of the granular bed, the remission of the infection, allowing grafting. The graft is partially integrated and plantar reconstruction is performed with sural reversal flap. The local and functional results are satisfactory, with the flap viability and the possibility of moving with support on the right leg, preventing the amputation of the shank. Negative pressure therapy has a multitude of advantages, it is preferable to conventional therapies, and it can have higher costs, but accelerates healing and improves the quality of life of the patient.
SARS-CoV-2 infections raise many practical concerns in a woman with multiple sclerosis (MS) during the perinatal period. On the other hand, the impact of COVID-19 on patients with MS and disease-modifying therapies (DMTs) is unknown. We report on a female patient who was treated with interferon beta 1a (IFNB-1a) for many years for relapsing-remitting multiple sclerosis (RRMS) until December 2018. She developed COVID 19 infection in April 2020, after giving birth to a healthy baby girl, five weeks before. She developed a mild right hemiparesis 2 weeks later, without cold symptoms. On admission, PCR for SARS-CoV-2 was positive, and she received antivirals and corticotherapy. One month later, specific IgG and IgM antibodies were negative. The patient did not develop immunity to COVID-19 infection. This report raises several problems. The focal deficit could be a real relapse or a pseudo-relapse due to SARS-CoV-2 and postpartum patient vulnerability. The treatment options in this particular case raise many challenges. The absence of antibodies after a SARS-CoV-2 infection raises a big question over the acquired immunity, the increased risk of reinfection, and the subsequent evolution of MS. The standard of care for a woman with MS and COVID-19 infection during the postpartum period must be explored and more precise recommendations must be established in the future.
The effectiveness of pharmacological therapies is supported and guaranteed by medical protocols, which are the result of long-lasting experiments and scientific research, of course adapted to the level of competence and functional capacity of the healthcare provider. Besides pharmacological effectiveness, the therapeutic regimens should be evaluated from the point of view of economic efficiency, by assessing the financial impact of drug consumption, in correlation with other indicators specific to medical management. A retrospective comparative study of drug used in a surgical section with a capacity of 25 beds, from a county hospital is described. Study objective was to identify the relationship of influence and determination between costs with drugs and other economic and financial indicators and the use of services; objectively evaluate the effectiveness of the protocols used to limit the development of antibiotic resistance, avoiding polypharmacy and improving costs related to drug use, but especially to determine the existence of deviations from these and generating causes. The implementation of medical protocols has led to a decrease in drug costs. Tracking drug use is an effective tool to increase the quality of medical services by avoiding polypharmacy, therapeutic errors and preventing the development of antibiotic resistance. All these aspects are supported by the implementation of medical protocols and, thus, drug use can be appreciated as a valid indicator of their effectiveness and efficiency.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.