The aim of our study was evaluation of prevalence of uncomplicated and complicated urinary tract infections (UTIs) among patients with UTIs associated with Gram - negative bacteria and analysis of prognostic risk factors in complicated UTIs. Weretrospectivelyanalyzed the medical records of inpatients with diagnosis of UTI based on clinical, biological and microbiological assay. Susceptibility tests for different antimicrobial categories were performed. Risk factors in complicated UTIs were correlated with pathogens� susceptibility. A total of 96 eligible patients were analyzed. Complicated UTIs were identified in 66.67% cases. The most frequent uropathogens isolated were E.coli and Klebsiella species. Exrtrarenal factors and nephropathic disease were the most common factors associatedwith an increased prevalence of multi -drug resistant isolates. Knowledge of the spectrum of the possible pathogens and local resistance patterns are very important for the antibacterial treatment outcome.
Background: Hepatitis C virus can be eradicated with antiviral therapy, thus reducing the risk of disease progression and death associated with the final stage of liver disease.
Methods: 241 patients received PrOD+RBV for 12 weeks. Clinical and laboratory data were assessed at baseline, week 4, 8, 12 (end of treatment, EOT), and 12 weeks after therapy (sustained virological response, SVR). Subsequently, biological and virological measurements were performed at least 48 weeks after obtaining SVR12 in responder patients.
Results: Per protocol SVR12 rate was 97,6%. Severe adverse events were reported in 3 patients (1.24%) and led to treatment discontinuation (liver decompensation). One 58-year-old patient who completed the treatment died before SVR evaluation due to acute mesenteric ischemia (not related to antiviral therapy). Baseline total bilirubin above 2 mg/dl can be considered a predictive factor for non-response to PrOD+RBV treatment (p = 0.004). Of the 30 patients evaluated at least 48 weeks after SVR no one presented relapses, with no statistically significant differences in biological parameters changes and no adverse events were noted during the 48-week follow up period.
Conclusion: Our study revealed the high effectiveness and good safety profile of PrOD +RBV in patients with genotype-1b HCV compensated cirrhosis (Child Pugh A) which were maintained during a 48-week period after treatment finalization.
The new coronavirus pandemic has brought into the light-on top of the strain it put on the medical services around the world-a variety of ethical issues in relation to how the treatment is being administered to the patients. Understanding the priority of treating COVID-19 patients, we still ask ourselves how effective these antiviral/immunomodulatory molecules are recommended by national/international protocols and which is the benefit/risk ratio in different categories of patients. To solve these dilemmas, we present the case of a 36year-old patient, admitted to our clinic in April 2020, with mild symptomatic SARS-CoV-2 infection. Given the suggestive clinical and paraclinical elements, we recommended treatment with lopinavir/ ritonavir according to national protocol, and we explained to patient the benefits of this treatment, as well as the possible side effects. The patient refused this treatment, but later accepted an alternative therapy, hydroxychloroquine. The evolution of clinical and paraclinical parameters allowed the patient to be discharged after 19 days. This apparently simple and solvable medical case becomes complicated when the patient complained about the violation of her rights and of certain articles from deontological code. Beyond the elements of subjectivism, it is necessary an ethical approach of this problem. After 9 months of pandemics, we can say that some anti-COVID -19 therapies have proven a practical effectiveness and others have been partially invalidated by clinical trials and removed from the guidelines, but can we say every information regarding anti -SARS-CoV-2 medication is absolutely clear or that ethical aspects are solved?
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.