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Siddiq D.M.,Baylor College of Medicine | Darouiche R.O.,Michael bakey Veteran Affairs Medical Center
Nature Reviews Urology | Year: 2012

Catheter-associated urinary tract infection (CAUTI) is the most common health-care-associated infection worldwide. Although not all cases of bacteriuria result in clinical infection, several hundred thousand episodes of CAUTI occur each year in the USA alone. The milieu in which the catheter is placed is highly conducive to bacterial colonization, biofilm formation on the catheter surface, and inevitable catheter-associated bacteriuria. A multitude of novel methods of CAUTI prevention have been described, including established approaches that are routinely recommended, such as the use of a secured, closed, silicone urinary catheter drainage system that mimics normal voiding, and newer strategies focusing on biocompatible catheter materials that cause minimal host inflammatory response and retard biofilm formation. Much recent research has focused on modification of the catheter surface by either coating or impregnation with antimicrobials or antiseptics. However, clinical trials that analyse cost-effectiveness and rates of antimicrobial resistance are awaited. More recently, innovative use of iontophoresis, vibroacoustic stimulation, bacterial interference and bacteriophage cocktails has been reported. © 2012 Macmillan Publishers Limited. All rights reserved. Source

Kayani W.T.,Baylor College of Medicine | Bandeali S.J.,Baylor College of Medicine | Lee V.-V.,Texas Heart Institute | Elayda M.,Texas Heart Institute | And 14 more authors.
International Journal of Cardiology | Year: 2013

Background: We determined whether pre-operative statin therapy is associated with a decrease in the incidence of infections after coronary artery bypass grafting (CABG). Methods: A retrospective cohort study of 6253 patients undergoing isolated CABG, from the Texas Heart Institute Database from January 1, 2000 to December 31, 2010 (3869 receiving statins and 2384 not receiving statins) was conducted. Primary outcome was the development of any postoperative infection (composite of deep-sternal wound infection, leg harvest-site infection, pneumonia, or sepsis) after CABG. Secondary outcome was the association between pre-operative statin use and individual incidence of each aforementioned infection. Logistic regression analyses were performed. Results: Incidence of any postoperative infection in patients who received statins pre-operatively was 6.5% compared to 8.3% in patients who did not receive statins. Pre-operative statin therapy was associated with a significant reduction in the primary outcome (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.60-0.90) in adjusted models. Among individual secondary outcomes, pre-operative statin therapy was associated with a reduced incidence of sternal wound infections (2.5% vs. 3.2%, OR 0.6, 95% CI 0.5-0.8) and leg harvest site infections (0.6% vs. 1.3%, OR 0.46, 95% CI 0.2-0.8). Pre-operative statin therapy was not associated with a reduced incidence of pneumonia or sepsis. Conclusion: Pre-operative statin use is associated with a decrease in overall incidence of post-operative infections after CABG. We propose immunomodulatory effects of statins leading to a dampening of inflammatory cascade as the cause of our findings. © 2012 Elsevier Ireland Ltd. All rights reserved. Source

Aslam F.,Michael bakey Veteran Affairs Medical Center | Aslam F.,Baylor College of Medicine | Ng B.,Baylor College of Medicine
Clinical Rheumatology | Year: 2010

Joint pains and swellings are routine complaints in rheumatology clinics. Infectious diseases may mimic common rheumatic conditions and thus need to be ruled out before initiating any immunosuppressive treatment. Mycobacterium marinum is an organism that can present with a typical arthritis picture. A 60-year-old gentleman with a complicated medical history presented with a right wrist swelling which was initially managed as a case of remitting seronegative arthritis. He eventually required tenolysis and the biopsy showed M. marinum. On inquiry, he was found to be an avid fisherman. This report discusses typical diagnostic pitfalls, literature review on the reported cases and treatment strategies. The most important point is to ask for occupational and hobby history in such cases. © Clinical Rheumatology 2010. Source

Sun H.-Q.,Baylor College of Medicine | Sun H.-Q.,Peking University | Chen H.-M.,Peking University | Yang F.-D.,Peking University | And 3 more authors.
American Journal on Addictions | Year: 2014

Background and Objectives Amphetamine-type stimulants (ATS) have quickly spread and been widely abused in many parts of the world, particularly in China. This review focuses on and describes the epidemiological trends and the advances of treatments of ATS in China. Methods A descriptive study based on literature identified from searches of the China National Knowledge Infrastructure (1979-2013), PubMed databases, hand-picked references, and online references with emphasis on epidemiology, treatment and traditional Chinese medicine. This review covers some traditional Chinese treatments and their complementary Western approaches. Results and Conclusions The epidemiological trends of ATS in China have led to its being 2.2 times the rate of morphine abuse and second only to marijuana abuse. The treatment programs in China have used traditional herbal approaches as well as acupuncture, often in combination with Western medications such as fluoxetine for depression associated with ATS abuse. Other herbal treatments have reversed the cardiac arrhythmias associated with ATS intoxication, and acupuncture has been used successfully for the protracted depressive and somatic symptoms of ATS withdrawal over a period of 3 months. Scientific Significance These traditional Chinese treatments may be increasingly available to the world, but will remain a consistent complementary therapy for ATS in China and the Far East, where ATS has become such a prevalent problem. © American Academy of Addiction Psychiatry. Source

Marshall D.F.,Baylor College of Medicine | Strutt A.M.,Baylor College of Medicine | Williams A.E.,Baylor College of Medicine | Simpson R.K.,Methodist Hospital Neurological Institute | And 3 more authors.
European Journal of Neurology | Year: 2012

Background and purpose: Despite common occurrences of verbal fluency declines following bilateral subthalamic nucleus deep brain stimulation (STN-DBS) for the treatment of Parkinson's disease (PD), alternating fluency measures using cued and uncued paradigms have not been evaluated. Methods: Twenty-three STN-DBS patients were compared with 20 non-surgical PD patients on a comprehensive neuropsychological assessment, including cued and uncued intradimensional (phonemic/phonemic and semantic/semantic) and extradimensional (phonemic/semantic) alternating fluency measures at baseline and 6-month follow-up. Results: STN-DBS patients demonstrated a greater decline on the cued phonemic/phonemic fluency and the uncued phonemic/semantic fluency tasks compared to the PD patients. For STN-DBS patients, verbal learning and information processing speed accounted for a significant proportion of the variance in declines in alternating phonemic/phonemic and phonemic/semantic fluency scores, respectively, whilst only naming was related to uncued phonemic/semantic performance for the PD patients. Both groups were aided by cueing for the extradimensional task at baseline and follow-up, and the PD patients were also aided by cueing for the phonemic/phonemic task on follow-up. Conclusions: These findings suggest that changes in alternating fluency are not related to disease progression alone as STN-DBS patients demonstrated greater declines over time than the PD patients, and this change was related to declines in information processing speed. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS. Source

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