Assessing the Effect of Piperacillin/Tazobactam on Hematological Parameters in Patients Admitted with Moderate or Severe Foot Infections

Introduction: Piperacillin/tazobactam is a commonly used antibiotic for the empirical treatment of severe diabetic foot infections. One of the most feared complications of this drug is the development of pancytopenia. The aim of this study was to determine whether the use of piperacillin/tazobactam caused any hematological changes in patients admitted with severe diabetes-related foot infections from a specialist multidisciplinary foot clinic. Specifically, looking at whether it caused anemia, leukopenia, neutropenia, or thrombocytopenia. Methods: A 1-year retrospective analysis of patients admitted to a tertiary care center for treatment of diabetes-related foot infection using piperacillin/tazobactam. Hematological indices, urea and electrolytes, and C-reactive protein (CRP) were recorded pretreatment, during treatment, and posttreatment. HbA1c, vitamin B12, folate, thyroid-stimulating hormone, and free thyroxin were also analyzed to exclude any potential confounders as a cause of pancytopenia. Results: A total of 154 patients were admitted between 1 January 2016 and 31 December 2016 who received piperacillin/tazobactam for severe diabetes-related foot infection. On admission, white cell count and CRP were raised and fell significantly within the first 48 h. Other hematological factors did not change. Five patients developed a mild pancytopenia, of which three were unexplained. Conclusion: In this relatively small cohort, pancytopenia did not occur. As such, piperacillin/tazobactam appeared to have a low risk of adverse hematological outcomes and remains the treatment of choice for severe diabetes-related foot infections

A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya.

BACKGROUND: Painful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale. METHODS: We invited patients attending the Benghazi Diabetes Centre who had diabetes for ≥ 5 years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined. RESULTS: Four hundred and fifty participants completed the study (age = 19 to 87 years, BMI = 17.6 to 44.2 kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6 months and 190/195 participants (97.4%) reported a S-LANSS score of ≥ 12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4 ± 6.5 years) was significantly higher compared with those without PDN (11.1 ± 4.6 years). Participants with PDN smoked tobacco for more years than those without pain (7.9 ± 12.3 years versus 1.1 ± 3.9 years respectively); had significantly higher fasting plasma glucose concentration (143.6 ± 29.3 mg/dl versus 120.0 ± 17.3 mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR = 25.85, 95% CI = 13.56-49.31), followed by smoking for men (OR = 8.28, 95% CI = 3.53-9.42), obesity (OR = 3.96, 95% CI = 2.25-6.96) and high fasting plasma glucose concentration (OR = 3.51, 95% CI = 1.99-6.21). CONCLUSION: The prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status

Comparative typological characteristics of central circulation of blood and physical capacity for sportsmen-swimmers and athletes-runners

The features of adjusting of central hemodynamic are examined for sportsmen, engaged in the sporting swimming and athletes in different positions of body and at the physical exercise. The differences of central blood circulation regulation in orthostatics, which are realized in hypokinetic direction in athletes and in eurkinetic one in swimmers, are shown. Insufficient optimization of system hemodynamic is shown for swimmers at implementation of the physical exercise in semy- and orthostatic position

ДОМИНИРУЮЩИЕ ПРИЧИНЫ ПОВЫШЕННОЙ ЗАБОЛЕВАЕМОСТИ ВИЧ-ИНФЕКЦИЕЙ, НОВАЯ ВОЛНА СРЕДИ НАРКОПОТРЕБИТЕЛЕЙ В ВОЛОГОДСКОЙ ОБЛАСТИ

To determine the possible causes of an increase in the of HIV infection rate in the Vologda Region. HIV cases within the Vologda Region, 169 maps of epidemiological survey of the HIV nidus, state federal statistical monitoring forms № 4 «Data on the results of test on antibodies to HIV», annual reports of Budgetary Institution of Health Care «Center for Prevention of Infectious Diseases», Vologda were used as a data for study. The most probable cause of the increase of HIV infection rate in the Vologda Region is activation of narcotic channels of HIV infection the share of which increased from 30,2% to 48,2% for the period of 2015 through 2017. The highest HIV infection detection rates were observed in people surveyed by the code «102» which in 2017was 5,0 per 100 surveyed, exceeding the rates for 2014 and 2015 in 2,7 and 3,6 times, correspondingly. The data of laboratory examination of patients for immune status at registration indicated a recent HIV infection of a part of patients, probably, in the last 2 years (CD4 was over 500 c/ml in 22% of examined). At the same time, there is a factor of accumulation of sources of HIV infection among IDUs who have long-standing infection and have been living with HIV for many years (CD4 is less than 500 c/ml in 22% of examined) without knowing about it. The authors regard the activation of injection channels of HIV infection as a dangerous relapse in the evolution of epidemic previously observed in the NWFD.Цель: определить вероятные причины роста заболеваемости ВИЧ-инфекцией в Вологодской области. Материалами для исследования послужили случаи регистрации ВИЧ-инфекции на территории Вологодской области, данные 169 карт эпидемиологического обследования очага ВИЧ-инфекции, данные федерального государственного статистического наблюдения — форма № 4 «Сведения о результатах исследований крови на антитела к ВИЧ», годовых отчетов БУЗ ВО «Центр по профилактике инфекционных заболеваний» г. Вологды. Наиболее вероятной причиной роста заболеваемости ВИЧ-инфекцией на территории Вологодской области является активизация наркотического пути передачи инфекции, доля которого за период 2015–2017 годов возросла с 30,2 до 48,2%. Наиболее высокие показатели выявляемости ВИЧ-инфекции были отмечены среди лиц, обследованных по коду 102, который в 2017 году составлял 5,0 на 100 обследованных, превысив показатели 2014 и 2015 годов в 2,7 и 3,6 раза соответственно. Данные лабораторного обследования пациентов на иммунный статус при постановке на учет свидетельствовали о недавнем инфицировании ВИЧ части пациентов, возможно, в последние 2 года (у 22% CD4-лимфоциты более 500 клеток/мкл). В то же время существует фактор накопления источников ВИЧ-инфекции среди потребителей инъекционных наркотиков, имеющих давнее заражение и живущих с ВИЧ на протяжении многих лет (у 20% CD4-лимфоциты менее 350 клеток/мкл), не зная об этом. Активацию инъекционного пути передачи авторы рассматривают как опасный, ранее наблюдаемый в Северо-Западном федеральном округе, рецидив в эволюции эпидемии.</p

Machine Vision for Obstacle Avoidance, Tripwire Detection, and Subsurface Radar Image Correction on a Robotic Vehicle for the Detection and Discrimination of Landmines

In a joint project, research partners across institutions combined specialties to develop a remotely-operable, multi-sensor, robotic device for the detection of land mines, unexploded ordnance (UXO), and improvised explosive devices (IEDs). The robotic detection device uses a novel subsurface radar with imaging and target classification to differentiate between dangerous landmines and harmless clutter. One important aspect of this project has been to develop a system for imaging the terrain and potential obstacles ahead of the moving vehicle. Three important tasks drive the need for this look-ahead imaging: obstacle avoidance, tripwire detection, holographic subsurface radar (HSR) image correction

Computer Analysis of Essential Hypertension Risk on the Base of Genetic and Environmental Factors

SECTION 6 COMPUTER DATA ANALYSIS AND MODELING IN APPLICATION

ЛЕТАЛЬНЫЕ ИСХОДЫ У БОЛЬНЫХ С ВИЧ-ИНФЕКЦИЕЙ, ПАРАЛЛЕЛИ С АДЕКВАТНОСТЬЮ ДИАГНОСТИКИ, ДИСПАНСЕРИЗАЦИИ И ЛЕЧЕНИЯ

The goal is to consider the lethality as an indicator of the adequacy and success of timely detection, clinical examination and treatment of patients with HIV infection. Materials and methods. A retrospective analysis of 913 deaths of HIV-infected patients in the Novgorod Region was carried out for the period from 2001 to 2017. The study included patients with previously known HIV status and patients with newly diagnosed HIV infection. Age, time (from the time of detection of HIV infection to death), clinical (causes of deaths) and other characteristics were taken into account. The conclusion. Every year, the number of deaths of HIV-infected patients increases, while the number of deaths diagnosed with AIDS is increasing yearly. The structure of deaths is dominated by cases caused by severe immunosuppression, which is a characteristic feature of this stage of the epidemic. The most likely cause of increased mortality is the late onset of treatment, low coverage of therapy and a large number of late-identified patients. The age structure of the deceased is dominated by persons 30–39 years old. The main cause of death is tuberculosis. The increase in deaths from tuberculosis depends on the number of patients with unstable social status. Other common causes of death are bacterial infections (pneumonia, sepsis, etc.), malignant neoplasms, toxoplasmosis, pneumocystis pneumonia. A similar structure of deaths is associated with late diagnosis and atypical course (rapid progression) of tuberculosis. Among the causes of death not related to HIV, a significant proportion is occupied by viral hepatitis in the cirrhotic stage, cardiovascular diseases, malignant neoplasms, drug overdoses, alcohol poisoning. The annual increase in lethal outcomes in the region is due to inadequate coverage and late onset of ARVT, a low percentage of prevention of opportunistic diseases at a critically low level of CD4 cells, weak adherence to medical examination and treatment. To increase the life expectancy of HIV-infected people, it is necessary to improve and expand programs for the prevention and treatment of HIV infection.Цель: рассмотреть летальность как показатель адекватности и успешности своевременного выявления, диспансеризации и лечения больных с ВИЧ-инфекцией. Материалы и методы. Проведен ретроспективный анализ 913 летальных исходов ВИЧ-инфицированных больных в Новгородской области за период с 2001 по 2017 год. В исследование вошли пациенты как с ранее известным ВИЧ-статусом, так и пациенты с впервые выявленной ВИЧ-инфекцией. Учитывались возрастные, временные (время от момента выявления ВИЧ-инфекции до смерти), клинические (причины летальных исходов) и другие характеристики. Заключение. Ежегодно увеличивается количество смертей ВИЧ-инфицированных больных, одновременно с этим ежегодно наблюдается увеличение количества смертей с диагнозом .СПИД.. В структуре смертей доминируют случаи, обусловленные выраженной иммуносупрессией, что является характерной особенностью настоящего этапа эпидемии. Наиболее вероятной причиной роста смертности является позднее начало лечения, низкий охват терапией и большое количество поздно выявленных больных. В возрастной структуре умерших доминируют лица 30–39 лет. Основная причина летальных исходов — туберкулез. Возрастание числа смертей от туберкулеза зависит от числа больных с нестабильным социальным статусом. Другими распространенными причинами летальных исходов являются бактериальные инфекции (пневмонии, сепсис и др.), злокачественные новообразования, токсоплазмоз, пневмоцистная пневмония. Подобная структура летальных исходов связана с поздней диагностикой и атипичным течением (быстрая прогрессия) туберкулеза. Среди причин смерти, не связанных с ВИЧ, существенную долю занимают вирусные гепатиты в цирротической стадии, сердечнососудистые заболевания, злокачественные новообразования, передозировки наркотическими средствами, отравления алкоголем. Ежегодное увеличение числа летальных исходов в регионе связано с недостаточным охватом и поздним началом АРВТ, низким процентом проведения профилактики оппортунистических заболеваний при критически низком уровне СD4клеток, слабой приверженностью к диспансеризации и лечению. Для увеличения продолжительности жизни ВИЧ-инфицированных необходимо совершенствование и расширение программ по профилактике и лечению ВИЧ-инфекции.</p