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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 | Interleukin-f is associated with cognitive function: the Northern Manhattan Study 显示文摘 | Wright CB Sacco RL Rundek T | 2006 | J Stroke Cerebrovasc Dis2006，，： | 1 |
| 3 | The global network: a prospective study of stillbirths in developing countries 显示文摘 | McClure EM Wright LL Goldenberg RL | 2007 | Am J Obstet Gynecol2007，197，3： | 1 |
| 4 | Developmental assessment of spinal cord and cortical evoked potentials after tibial nerve stimulation :effects of age and stature on normative data during ehildhood显示文摘 | Gilmore RL Bass NH Wright EA | 1985 | Electroencephalogr Clin Neurophysiol1985，62，4： | 1 |
| 5 | Modeling early retinal development with human embryonic and induced pluripotent stem cells 显示文摘 | Meyer JS Shearer RL Capowski EE Wright LS Wallace KA McMiUan EL | 2009 | Proc Natl Acad Sci USA2009，106，16： | 1 |
| 6 | A survey of possible etiologic agents in postoperative craniotomy infections显示文摘 | Wright RL | 1996 | J Neurosurg1996，25，： | 1 |
| 7 | Dolichoectasia an evolving arterial disease显示文摘 | Gutierrez J Sacco RL Wright CB | 2011 | Nat Rev Neurol2011，7，1： | 1 |
| 8 | Aggregate stability and glomalin in ahernative crop rotations for the central Great Plains 显示文摘 | WRIGHT SF ANDERSON RL | 2000 | Biology and Fertility of Soils2000，31，： | 1 |
| 9 | Cardiac studies in patients treated with depsipeptide, FK228, in a phase II trial for T-cell lymphoma显示文摘 | Piekarz RL Frye AR Wright J J | 2006 | Clin Cancer Res2006，12，12： | 1 |
| 10 | Dolichoectasia-an evolving arterial disease显示文摘 | Gutierrez J Sacco RL Wright CB | 2011 | Nat Rev Neurol2011，7，1： | 1 |
| 11 | A survey of possible etiologic agents in postoperative craniotomy infections 显示文摘 | Wright RL | 1966 | J Neurosurg1966，25，： | 1 |
| 12 | Disinfection procedures:their effect on the dimensional accuracy and surface quality of irreversible hydrocolloid impression materials and gypsum casts显示文摘 | Wright PS Maryan C | 2002 | Dent Mater2002，18，2： | 1 |
| 13 | Cardiac studies in patients treated with depsipeptide, FK228, in a phase II trial for T-cell lymphoma显示文摘 | PIEKARZ RL FRYE AR WRIGHT JJ | 2006 | Clin Cancer Res2006，12，12： | 1 |
| 14 | Perioperative complica-tions of trabeculectomy on previously untreated eyes of patients withopen-angie glaucoma in the CIGTS 显示文摘 | Wright MM Jampel HD Gross RL | 2002 | Invest Ophthalmol Vis Sci2002，43，13： | 1 |
| 15 | Chronic stress leaves novehy-seeking behavior intact while impairing spatial recognition memory in the Y-maze 显示文摘 | Wright RL Conrad CD | 2005 | Stress2005，8，2： | 1 |
| 16 | Interleukin-6 is associated with cognitive function: the Northern Manhattan Study显示文摘 | Wright CB Sacco RL Rundek TR | 2006 | J Stroke Cerebrovasc Dis2006，15，： | 1 |
| 17 | Validity of the assessment of quality of life(AQOL) utility instrument in patients with oper, able and inoperable lung cancer显示文摘 | Manser RL Wright G Byrnes G | 2006 | Lung Cancer2006，53，2： | 1 |
| 18 | Dolichoectasia-an evolving arterial disease显示文摘 | Gutierrez J Sacco RL Wright CB | 2011 | Nat Rev Neural2011，7，1： | 1 |
| 19 | Interleukin-6 is associated with cognitive function:the Northern Manhattan Study显示文摘 | Wright CB Sacco RL Rundek T | 2006 | J Stroke Cerebro- vasc Dis2006，15，1： | 1 |
| 20 | Dolichoectasia-an evolving arterial disease显示文摘 | Gutierrez J Sacco RL Wright CB | 2011 | Nat Rev Neurol2011，7，： | 1 |
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