Clinical efficacy and safety of prolonged versus intermittent administration of antipseudomonal beta-lactam antibiotics in adults with severe acute infections: A meta-analysis of randomized controlled trials

Introduction: In order to compare the clinical efficacy and safety of prolonged versus intermittent antipseudomonal beta-lactam antibiotic infusion for the treatment of severe acute infections in adult patients, a meta-analysis of randomized controlled trials (RCTs) was performed. Methods: We systematically searched MEDLINE and Cochrane Library databases until December 2022. The outcomes were all-cause mortality, clinical success, microbiological eradication and adverse events. The pooled risk ratios (RR) were estimated by the fixed or random effect methods according to heterogeneity statistics. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of evidence for each outcome. Results: Twenty eligible RCTs with 2081 participants were included in the meta-analysis. The risk of all-cause mortality was significantly lower in the prolonged infusion group than in the intermittent infusion group (RR 0.77, 95% confidence interval [CI] 0.63–0.95, p = 0.01, I2 = 0%; moderate certainty). Treatment with prolonged infusion showed significant benefit in clinical success (RR 1.09, 95% CI 1.02–1.17, p = 0.008, I2 = 19%; moderate certainty). There were no significant differences in microbiological eradication (RR 1.12, 95% CI 0.99–1.28, p = 0.07, I2 = 49%; low certainty), any adverse events (RR 0.96, 95% CI 0.86–1.08, p = 0.50, I2 = 27%; moderate certainty) and serious adverse events (RR 0.99, 95%CI 0.70–1.39 p = 0.95, I2 = 0%; low certainty). Conclusions: Prolonged antipseudomonal beta-lactam infusion probably decreases all-cause mortality. Additionally, it probably increases clinical success in adults with severe acute infections. This infusion strategy may result in little to no difference in microbiological eradication and is probably not associated with a rise in any adverse events.The evidence suggests that prolonged infusion may not increase serious adverse events

Prediction of Mortality in Patients with Sepsis Due to Gram-negative Bacteremia: Pitt Bacteremia Score, qSOFA, SIRS

Introduction: Sepsis is a syndrome of physiologic, biochemical and pathologic abnormalities induced by infection and has been associated with high mortality and morbidity. This study aimed to compare Systemic Inflammatory Response Syndrome (SIRS) criteria, Pitt bacteremia score and quick Sequential Organ Failure Assessment (qSOFA) for the prediction of mortality in patients with sepsis due to Gram-negative bacteremia

Power Optimization of Embedded Memory Systems via Data Remapping

In this paper, we provide a novel compile-time data remapping algorithm that runs in linear time. This remapping algorithm is the first fully automatic approach applicable to pointer-intensive dynamic applications. We show that data remapping can be used to significantly reduce the energy consumed as well as the memory size needed to meet a user-specified performance goal (i.e., execution time) -- relative to the same application executing without being remapped. These twin advantages afforded by a remapped program -- improved cache and energy needs -- constitute a key step in a framework for design space exploration: for any given performance goal, remapping allows the user to reduce the primary and secondary cache size by 50%, yielding a concomitant energy savings of 57%. Additionally, viewed as a compiler optimization for a fixed processor, we show that remapping improves the energy consumed by the cache subsystem by 25%. All of the above savings are in the context of the cache subsystem in isolation. We also show that remapping yields an average 20% energy saving for an ARM-like processor and cache subsystem. All of our improvements are achieved in the context of DIS, OLDEN and SPEC2000 pointer-centric benchmarks

The Relationship between Obesity and Oxidative Stress and Cardiac Markers

Obesity is one of the most even leading issue for the last era but however the reasons for this epidemic could not been explained clearly yet. We aimed to investigate the relationship between obesity, and myoglobin and homocysteine in means of cardiac markers and the levels of nitric oxide in means of oxidative stress and leptin. Study populations consisted of 30 patients with obesity and 30 healthy volunteers as control group. Serum nitric oxide, homocysteine, leptin and myoglobin were higher in obese individuals compared to controls. Nitric oxide level was related to myoglobin levels and seems to alter the myoglobin concentration. A negative and strong correlation was defined for myoglobin with both gender and age. There was a positive correlation between Body Mass Index and homocysteine. This is one of the studies investigating the relationship between nitric oxide as an oxidation marker homocysteine and myoglobin as cardiac markers, and leptin with obesity to lighten the complex relationship for the issue. [Med-Science 2015; 4(2.000): 2087-97

Design Space Optimization of Embedded Memory Systems via Data Remapping

In this paper, we provide a novel compile-time data remapping algorithm that runs in linear time. This remapping algorithm is the first fully automatic approach applicable to pointer-intensive dynamic applications. We show that data remapping can be used to significantly reduce the energy consumed as well as the memory size needed to meet a user-specified performance goal (i.e., execution time) -- relative to the same application executing without being remapped. These twin advantages afforded by a remapped program -- reduced cache size and energy needs -- constitute a key step in a framework for design space exploration: for any given performance goal, remapping allows the user to reduce the primary and secondary cache size by 50%, yielding a concomitant energy savings of 57%. Additionally, viewed as a compiler optimization for a fixed processor, we show that remapping improves the energy consumed by the cache subsystem by 25%. All of the above savings are in the context of the cache subsystem in isolation. We also show that remapping yields an average 20% energy saving for an ARM-like processor and cache subsystem. All of our improvements are achieved in the context of DIS, OLDEN and SPEC2000 pointer-centric benchmarks

Smoking status of pulmonologists who are members of Turkish thoracic society and factors related to their being a smoker = Türk toraks derneǧi üyesi göǧüs hastalıkları hekimlerinin sigara i̇çme durumu ve i̇lişkili faktörler

Objective: If smoking habit among physicians in a country is common as it is in the general population, it is a particular problem for national tobacco control studies. The study aimed to investigate the smoking status of pulmonologists who are members of the Turkish Thoracic Society (TTS), and factors related with being a smoker. Material and Methods: Web-questionnaires were e-mailed to members of TTS by the TTS secretary from June 2010-February 2011. Only pulmonologists were included in the study. To analyse possible predictors of smoking smokers were categorized as ever smokers and never smokers. Possible predictors were sex, being graduated before/after 2004, urban/suburban working place, being academician or not, having education on smoking cessation help, experienced in smoking cessation outpatient clinic or not. Results: Web questionnaires of 699 pulmonologists were reviewed. Of the participants, 65.2% were female and the mean age was 39.4±9.0 (25-72); 69% were non-smokers, 21.1% were ex-smokers, and 9.9% were current smokers. Never smokers were mostly included in the group of pulmonologists younger than 40 years old (p=0.001). The number of never smokers with experience in smoking cessation outpatient clinic was higher than the number without any experience (72.1% and 67.1%, respectively; p=0.03). Smoking was 1.8-fold more likely among males (95% confidence interval-CI 1.2-2.5) and 1.8-fold more likely among those graduated before 2004 (95% CI 1.1-3.1); 66.7% of current smokers were in the contemplation stage. The number of cases in contemplation stage were mostly among regular smokers (p=0.001). Conclusion: The results of this study suggesting relatively low prevalence of smoking among pulmonologists are important for tobacco control