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| 1 | Antibiotic prophylaxis in variceal hemorrhage:Timing,effectiveness and Clostridium difficile rates显示文摘AIM:To investigate if antibiotics administered within 8 h of endoscopy reduce mortality or increase the incidence of Clostridium difficile infection(CDI).METHODS:A 2-year retrospective analysis of all patients who presented with first variceal hemorrhage was undertaken.The primary outcome measure was 28-d mortality.Secondary outcome measures were 28-d rebleeding rates and 28-d incidence of CDI.All patients were admitted to a tertiary liver unit with a consultantled,24-h endoscopy service.Patients received standard care including terlipressin therapy.Data collection included:primary and secondary outcome measures,timing of first administration of intravenous antibiotics,eti-ology of liver disease,demographics,endoscopy details and complications.A prospective study was undertaken to determine the incidence of CDI in the study population and general medical inpatients admitted for antibiotic therapy of at least 5 d duration.Statistical analysis was undertaken using univariate,non-parametric tests and multivariate logistic regression analysis.RESULTS:There were 70 first presentations of variceal hemorrhage during the study period.Seventy percent of cases were male and 65.7% were due to chronic alcoholic liver disease.In total,64/70(91.4%) patients received antibiotics as prophylaxis during their admission.Specifically,53/70(75.7%) received antibiotics either before endoscopy or within 8 h of endoscopy [peri-endoscopy(8 h) group],whereas 17/70(24.3%) received antibiotics at > 8 h after endoscopy or not at all(non peri-endoscopy group).Overall mortality and rebleeding rates were 13/70(18.6%) and 14/70(20%),respectively.The periendoscopy(8 h) group was significantly less likely to die compared with the non peri-endoscopy group [13.2% vs 35.3%,P = 0.04,odds ratio(OR) = 0.28(0.078-0.997)] and showed a trend towards reduced rebleeding [17.0% vs 29.4%,P = 0.27,OR = 0.49(0.14-1.74)].On univariate analysis,the non peri-endoscopy group [P = 0.02,OR = 3.58(1.00-12.81)],higher model for end-stage liver disease(MELD) score(P = 0.02),presence of hepatorenal syndrome [P < 0.01,OR = 11.25(2.24-56.42)] and suffering a clinical episode of sepsis [P = 0.03,OR = 4.03(1.11-14.58)] were significant predictors of death at 28 d.On multivariate logistic regression analysis,lower MELD score [P = 0.01,OR = 1.16(1.04-1.28)] and periendoscopy(8 h) group [P = 0.01,OR = 0.15(0.03-0.68)] were independent predictors of survival at 28 d.The CDI incidence(5.7%) was comparable to that in the general medical population(5%).CONCLUSION:Antibiotics administered up to 8 h following endoscopy were associated with improved survival at 28 d.CDI incidence was comparable to that in other patient groups. | Matthew RL Brown Graeme Jones Kathryn L Nash Mark Wright Indra Neil Guha | 2010 | World Journal of Gastroenterology2010，16，42： | 13 |
| 2 | Integrated Control of Root and Crown Rot in Sugar Beet: Combined Effects of Cultivar, Crop Rotation, and Soil Tillage显示文摘 | Cord Buhre Christian Kluth Klaus Barcky Bemward M?rl?nder and Mark Varrelmann | 2009 | Plant Disease2009，93，2： | 1 |
| 3 | Islet amyloid:a Critical entiy in the pathogenesist of type 2 diabetes显示文摘 | Hull RL Westemark GT West mark P | 2004 | Clin Endocrinol Metab2004，89，8： | 1 |
| 4 | Organizing pneumonia and pulmonary lymphatic architecture in diffuse alveolar damage显示文摘 | Mandal RV Mark E J Kradin RL | 2008 | Hum Pathol2008，39，8： | 1 |
| 5 | Heart Rate,Neuroendocrine, and Ira-munological Reactivity in Response to an Acute Laboratory Stressor显示文摘 | Mark RL Robert A Jan AM | 2001 | Psychosomatic Medicine2001，63，： | 1 |
| 6 | Diffuse alveolar hemorrhage in hematopoietic stem cell transplant recipients 显示文摘 | Bekele A Ayalew T Mark RL | 2002 | Am J Respir Care Med2002，166，5： | 1 |
| 7 | Benign lymphoid disorders of the lung, with a theory regarding their development 显示文摘 | Kradin RL Mark EJ | 1983 | Hum Pathol1983，14，10： | 1 |
| 8 | Transfusion-related acute lung injury显示文摘 | Mark RL Michael AG Michael AM | 2004 | Chest Jul2004，126，1： | 1 |
| 9 | Impression management:a literature review and two-component model显示文摘 | Robbin MK | 1990 | Psychological Bulletin1990，107，1： | 1 |
| 10 | Heart rate,neuroendochne,and immunological reactivity in response to an acute laboratory stressor显示文摘 | Mark RL Robet A Jan AM | 2001 | Psychosom Med2001，63，： | 1 |
| 11 | Heart Rate, Neuroendocrine and Immunnological Reactivity in Response to an Acute Laboratory Stressor 显示文摘 | Mark RL Robert A Jan AM | 2001 | Psychosomatic Medicine2001，63，： | 1 |
| 12 | Heart rate, neuroendocrine and immunological reactivity in response to an acute laboratory stressor显示文摘 | Mark RL Robert A Jan AM | 2001 | Psychosonatic Med2001，63，3： | 1 |
| 13 | Intrathecal midazolam for the treatment of chronic mechanical low back pain: a controlled comparison with epidural steroid in a pilot study显示文摘 | Serrao JM Marks RL Morley SJ | 1992 | Iain1992，48，1： | 1 |
| 14 | Common Variation in SIMI Is Reproducibly Associated With BMI in Pi rna Indians显示文摘 | Traurig M Mark J Hanson RL | | Diabetes0，58，7： | 1 |
| 15 | Transfusion-related acute lung injury显示文摘 | Mark RL Michael AG Michael AM | 2004 | Chest Jul2004，126，1： | 1 |
| 16 | Volume-length impact of lateral jaw resections on complication rates显示文摘 | Rachel JD Marks SC | 1999 | Arch Otolaryngol Head Neck Surg1999，125，1： | 1 |
| 17 | Evidence-based assessment: patient,procedure,or operator factors associated with ERCP complications显示文摘 | Flamm CR Bohn RL Mark DH | 2002 | Gastrointest Endosc2002，56，6： | 1 |
| 18 | Dyspepsia due to eosinophilic gastroenteritis 显示文摘 | Kalantar SJ Marks RL Lambert JR | 1997 | Dig Dis Sci1997，42，11： | 1 |
| 19 | Transfusion-related acute lung injury显示文摘 | Mark RL Michael AG Michael AM | 2004 | Chest Jul2004，126，1： | 1 |
| 20 | Intrathecal midazolam for the treatment of chronic mechani-cal low back pain:a controlled comparison with epidural steroid in a pilot study显示文摘 | Serrao JM Marks RL Morley S J | | 0，，： | 1 |
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