Based on available data, the use of piperacillin-tazobactam (PTZ) and FEP in the treatment of ESBL-producing Enterobacteriaceae cannot be widely recommended. However, certain infections and patient characteristics may support for effective use of these alternative agents. In the treatment of infections caused by AmpC-producing Enterobacteriaceae, FEP has been shown to be a clinically useful carbapenem-sparing alternative. Carbapenems and FEP share many structurally similar characteristics in regards to susceptibility to AmpC β-lactamases, which further create confidence in the use FEP in these situations. Patient and infection specific characteristics should be used to employ FEP optimally.

This is the first study to demonstrate a reduction in antipsychotic continuation at transition from the MICU after implementation of an antipsychotic discontinuation bundle in ICU patients. We believe this bundle allows for safer transitions of care from the MICU and decreases unnecessary antipsychotic therapy.

The haemodynamic effects of dobutamine were studied in I4 patients with chronic congestive cardiac failure. Heart rate, central venous, pulmonary arterial, pulmonary wedge, and aortic pressures, aortic dp/dt, cardiac output, cardiac index, stroke volume, and pulmonary and systemic vascular resistances were measured or derived. Dose-response curves were obtained by recording all measurements before and after intravenous infusion of dobutamine at rates of 2.5, 5, and IO ,ug/kg per min for periods of 30 minutes each. Significant increases in mean values were observedfor cardiac output from 3.7 to 6.4 1/min (82%), for stroke volume from 44 to 64 ml (39%), and aortic dp/dt from 692 to 1414 mmHg/s (92.0 to x88.i kPa/s) (76% (Fig. i).This investigation was developed to study the dose-related effects of dobutamine in a group of Received I5 November 1974. patients with chronic congestive heart failure. Haemodynamic and renal parameters were measured during the administration of graded increments of the drug. The present report describes initial clinical observations with the use of this new inotropic agent. Subjects and methodsFourteen patients (8 men and 6 women) whose ages ranged from 24 tO 74 years were investigated. All had cardiac failure secondary to myocardial, coronary, or valvular disease. Patients considered for this investigation received a complete verbal and written description of the procedure and of the potential effects of the drug to be administered. Consent was subsequently obtained in writing. The patients were allocated to 2 groups according to their functional class (New York Heart Association Classification) and cardiac index at the time of the study. Group A consists of 4 patients in functional class II, clinically 'compensated', and with a cardiac index more than 3 1 minl -m-2 on basal conditions. Group B consists of io patients in functional class III or IV, with clinical evidence of severe congestive failure, and with a cardiac index less than 3 1 min -m -2. Digitalis, when previously administered, was discontinued 24 to 48 hours preceding the study. Standard haemodynamic techniques and instrumentation were used. Catheters were placed in the superior vena cava and pulmonary artery via antecubital vein cut-down or femoral

Drawing primarily on the construct of psychological buffer, the purpose of this study was to explore the extent to which racism‐related stress and ethnic identity are determinants of career aspirations. A total of 163 African American college students from a predominately White Midwestern university participated in the study. A moderation regression analysis was conducted. Results indicate that ethnic identity interacted with racism‐related stress (p= .04) to predict career aspirations. In other words, as racism‐related stress increases in the context of low identity development, career aspirations decrease. Conversely, as perceived racism increases in the context of high identity development, career aspirations increase. Implications for professionals and future research in the field of career counseling are discussed.