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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 | Effects on reproduction performance of administration of GnRH to early postpartum dairy cows显示文摘 | Nash Jr J G Ball L Olson J D | 1980 | J Anim Sci1980，50，： | 2 |
| 3 | Anthropology and tourism 显示文摘 | Dennison Nash Valene L Smith | 1991 | Annals of Tourism Research1991，18，1： | 1 |
| 4 | Kinetics of Reduction of Plutonium(Ⅵ) and Neptunium( Ⅵ ) by Sulfide in Neutral and Alkaline Solution显示文摘 | Nash K L Cleveland J M Sullivan J C | 1986 | Inorg Chem1986，25，： | 1 |
| 5 | Meteorology of the polar vortex: Spring 1997显示文摘 | COY L NASH E R NEWMAN P A | 1997 | Geophys Res Lett1997，24，： | 1 |
| 6 | Time-dependent electron temperature diagnostics for high-power aluminum Z pinch plasmas显示文摘 | Sanford T W L Nash T J Mock R C | 1997 | RevSci Instrurn1997，68，1： | 1 |
| 7 | The use of eonfocal microscopy for the examination of El2 sheet plastinated human tissue显示文摘 | Phillips M Nash L Barnett R | 2002 | J Int Sue Plastination2002，17，1： | 1 |
| 8 | Configuration of the connective tissue in the posterior atlanto-oecipital interspace: a sheet plastination and eonfocal microscopy study显示文摘 | Nash L Nicholson H Lee AS | 2005 | Spine2005，30，12： | 1 |
| 9 | One-dimensional consolidation testing for soft clay from Bothkennar显示文摘 | Nash D F T Sills G C Davison L R | 1992 | Geotechnique1992，42，2： | 1 |
| 10 | Green fluorescent protein: green cell do not always indicate gene expression 显示文摘 | NASH K L LEVER A M | 2004 | Gene Therapy2004，11，11： | 1 |
| 11 | Spinal cord moni- toring during operative treatment of the spine显示文摘 | Nash C L Lorig R A Schatzinger L A etal | 1977 | Clin Orthop Relat Res1977，126，： | 1 |
| 12 | Anthropology and tourism 显示文摘 | Dennison Nash Valene L Smith | 1991 | Annals of Tourism Research1991，18，1： | 1 |
| 13 | One-dimensional consolidation testing for soft clay from Bothkennar显示文摘 | NASH D F T SILLS G C DAVISON L R | 1992 | Geotechnique1992，42，2： | 1 |
| 14 | The Financial and Operating Performance of Newly Privatized Firms: An International Empirical Analysis显示文摘 | Megginson W L R C Nash M Van Randenborgh | 1994 | Journal of Finance1994，49，2： | 1 |
| 15 | Share Issue Privatizations as Financial Means to Political and Economic Ends 显示文摘 | Jones S L W L Megginson R C Nash J M Netter | 1999 | Joumal of Financial Economics1999，53，2： | 1 |
| 16 | A novel method of surface modification for steel by plasma electrolysis carbonitriding显示文摘 | Shen D J Wang Y L Nash P | | 0，，： | 1 |
| 17 | Sensitivity of streamflow in the Colorado basin to climatic changes显示文摘 | Nash L L Gleick P H | 1991 | Journal of Hy- drology1991，125，3： | 1 |
| 18 | The financial and operating performance of newly privatized firms:an international empirical analysis显示文摘 | Megginson W L Nash R C Randenborgh M | 1994 | Journal of Finance1994，49，： | 1 |
| 19 | Effect of remnant vegetation, pesticides, and farm management on abundance of the beneficial predator Notonomus gravis (Chaudoir) (Coleoptera: Carabidae) 显示文摘 | Nash M A Thomson L J Hoffmann A A | 2008 | Biological Control2008，46，2： | 1 |
| 20 | Anthropology and Tourism显示文摘 | | 1991 | Annals of Tourism Research1991，，18： | 1 |
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