In order to evaluate the efficacy and safety of aztreonam in hospitalized patients with upper urinary tract infections (UTI), a comparative clinical study with cefuroxime was performed. 62/60% (aztreonam/cefuroxime) of the patients had a complicating factor, mostly obstructive uropathy. I.v. bolus injections were used at a dose of 1 g aztreonam or 1.5 g cefuroxime t.i.d., for a mean of 8.2 days (range: five to 14 days) except in patients with bacteraemia, who received a mean of 10.3 days (range: seven to 13 days) of therapy. 89% of the patients treated with aztreonam and 87% of those who received cefuroxime showed clinical cure and the bacteriological cure rate at one week post-therapy was 70% and 73% in the respective groups. The relapse/reinfection rate was high with both drugs; bacteriological cure at one month post-therapy was only 43% after aztreonam and 40% after cefuroxime. This suggests that these infections may need longer treatment times. Superinfections, mostly asymptomatic urinary colonization, occurred in 7% and 3%, respectively, and adverse reactions in 23% and 12%, respectively, of the patients treated with aztreonam or cefuroxime, the majority being mild and reversible and only 3% and 3%, respectively, requiring discontinuation of the therapy. The t 1/2 for aztreonam following a 1 g i.v. bolus was 2.0 h in six patients with creatinine clearance above 80 ml/min and 3.0 h in seven patients with creatinine clearance between 35-75 ml/min.

Adolescent↗

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The challenging case conference: an integrated approach to resident education and support.

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Internship and Residency↗

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Measurement and improvement of humanistic skills in first-year trainees.

The American Board of Internal Medicine (ABIM) has recently emphasized the development of humanistic skills in trainees. Using video technology, transition outpatient visits of first-year house officers in a primary care training program were evaluated for the presence or absence of nine humanistic skills before and after the initiation of an instructional program to reinforce the skills. Thirteen videotaped PGY-1 encounters constituted the preintervention group and 16 videotaped PGY-1 encounters constituted the postintervention group. The preintervention group performed a mean of 1.38 skills while the postintervention group performed a mean of 3.56 skills, a statistically significant improvement (p less than 0.05). The authors conclude that an educational approach that focuses on specific elements of interactions facilitates the incorporation of skills associated with humane medical care.

Clinical Competence↗

PubMedDate not supplied

Analysis of phosdrin in vegetables using gas-liquid chromatography.

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Butyrates↗