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Characterization of the Ear Canal Bacterial Flora Present in Hearing Aids (HA) Wearing Subjects

Advances in Microbiology 2019年第7期9卷 616-628页

作者： Marta Aleandri Cecilia Ambrosi Maria Stefania Lepanto Antonietta Lucia Conte Massimiliano Marazzato Catia Longhi Mauro Nicoletti Carlo Zagaglia Paola Goldoni Francesco Bussu Roberta Anzivino roberto gallus Maria Pina Battista Maria Pia Conte Anna Teresa Palamara Department of Public Health and Infectious Diseases “Sapienza” University of Rome Rome Italy Dani Di Giò Foundation-Onlus Rome Italy Department of Medical Oral and Biotechnological Sciences University “G. D’Annunzio” Chieti Italy Institute of Otolaryngology “Cattolica del Sacro Cuore” University Agostino Gemelli Polyclinic Rome Italy Otolaryngology Mater Olbia Hospital Olbia Italy Department of Public Health and Infectious Diseases “Sapienza” University of Rome Laboratory Affiliated to Institute Pasteur Italia Cenci-Bolognetti Foundation Rome Italy San Raffaele Pisana IRCCS Telematic University Rome Italy

The use of hearing aids (HA) is considered a predisposing factor for ear microbial infections. We undertook this study to compare the presence and nature of the microbial flora inhabiting of ears of HA and non-HA (nHA) users. Swab samples of the ears of HA and nHA users were collected from the Institute of Otolaryngology, “Cattolica del Sacro Cuore” University “Agostino Gemelli”, Rome, Italy. Swab samples were taken from the ear canal of 57 HA and 33 nHA users. The components of the microbial flora present on each swab sample were identified and characterized at the level of species. A total of 41 different bacterial species were identified. A statistically significant prevalence of polymicrobial communities was found in ears presenting signs of inflammation (2.5 ± 1.7 vs 2.1 ± 1.3;P = 0.02) and in HA users (2.3 ± 1.2 vs 1.7 ± 1.0;P = 0.002). Few putative pathogens were detected. Candida albicans spp. was not isolated in our study. A small number of swab samples presented no microbial growth. Bacterial species isolated from HA users with and without inflammation were assayed for the ability to form biofilm. Among gram-positive and gram-negative bacteria, S. aureus, CoNS, P. aeruginosa and K. pneumoniae were found to be strong biofilm producers. S. aureus and P. aeruginosa, isolated only from the ears of HA and nHA users presenting signs of inflammation, were further analyzed for their antibiotic-resistance profile and characterized by the Multilocus Sequence Typing (MLST) assay. The highest rates of antibacterial resistance were in S. aureus to penicillin (75.5%) and in P. aeruginosa, to amoxicillin-clavulanic acid, cefotaxime, ertapenem, tigecycline and trime-thoprim-sulfamethoxazole (100%). Moreover, three S. aureus strains (37.5%) were methicillin-resistant (MRSA). Of the eight S. aureus isolates, we identified six sequence types (ST) indicating that 75% are likely independent clones. For what it concerned P. aeruginosa, six different STs were assigned. Interesti

关键词： Ear Bacterial Flora Hearing Aids Acute Otitis Externa

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Meta‐Analysis in Medical Research: The Handbook for the Understanding and Practice of Meta‐Analysis

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2005年

作者： Gioacchino Leandro Giuseppe gallus

ISBN: (数字)9780470994894

ISBN: (纸本)9781405127332

This book is a joint package of a practical manual on how to undertake meta-analysis in medicine together with an accompanying CD-ROM . This provides individuals with access to meta-analysis software and the instructions and guidance on how to undertake them. The software package contains a computer program 'Metanalysis' which performs statistical analyses for the meta-analysis. It has some unique features currently not available in other meta-analysis software packages: ability to import graphics into Word, PowerPoint etc Galbraith's plots cumulative meta-analysis number needed to treat publication bias assessment The graphics generated by the software are in a format compatible with Microsoft PowerPoint. Click here to view sample graphics. Order your copy online today!

关键词： Publication bias.

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Outcome of non-variceal acute upper gastrointestinal bleeding in relation to the time of endoscopy and the experience of the endoscopist: A two-year survey

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World Journal of Gastroenterology 2005年第45期11卷 7122-7130页

作者： Fabrizio Parente Andrea Anderloni Stefano Bargiggia Venerina Imbesi Emilio Trabucchi Cinzia Baratti Silvano gallus Gabriele Bianchi Porro Gastroenterology Unit Gastrointestinal Unit Academic Department of Gastroenterology Department of Accident and Emergency and Postgraduate School of General Surgery Mario Negri Pharmacological Institute

AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching ***: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were ***: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of *** analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of *** multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for re

关键词： Non-variceal acute GI bleeding Timeof endoscopy Surgeon's experience Endoscopic hemostasis

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Characterization of the Ear Canal Bacterial Flora Present in Hearing Aids (HA)Wearing Subjects

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Advances in Microbiology（微生物学） 2019年第7期

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Immediate mandibular reconstruction of a u.s. navy seal with a free fibula flap following osteoradionecrosis with pathological fracture

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中国口腔颌面外科杂志 2008年第B5期6卷 218-219页

作者： Ferguson, B Caballero, H. Cole, S. Hatt, H. Bach, K. Douglas, T. gallus, K. Laughlin, R. Dental Department Naval Medical Center Suit 206 34800 BobWilson Dr San Diego CA 92134 U.S.A.

The number of U。S。Navy SEALs that serve within U。S。Special Operations Command (SOCOM) is fewer than 2,500; this is an extremely small number when compared to the 1.5 million total U。S。military personnel currently serving on active duty。When a highly-trained highly-specialized service person is injured or medically incapacitated, it is extremely important to return him to an operational status as soon as possible。Due to the physical requirements of these personnel, reconstruction options can be limited。We present a U。S。Navy SEAL who was diagnosed with osteoradionecrosis (ORN) and a pathologic fracture of the mandible。The gamet of reconstruction options were considered。A flee fibular flap for mandibular reconstruction allowed the surgical team to complete a one-stage reconstruction with minimized functional disability, which permitted the patient a fully operational return to the SOCOM community。Case report: A 41yo male active duty Navy personnel with a history of squamous cell cancer of the base of tongue (T1N2bM0) was diagnosed with ORN。Initial treatment consisted of the Marx-University of Miami Protocol for Hyperbaric oxygen therapy。He responded with complete soft tissue coverage of the exposed bone to the right mandible。One month later, the patient, returned to the Otolaryngology Department with recurrence of exposed bone to the right mandible。He was referred to the Oral and Maxillofacial Surgery clinic at Navy Medical Center San Diego for evaluation and treatment。Surgical debridement of right mandible to bleeding bone leaving an intact inferior border was performed。

关键词：颚修复方法整形技术腓骨放射性骨坏死

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口服Xa因子直接抑制剂rivaroxaban(BAY 59-7939)治疗近端深静脉血栓:ODIXa-DVT(急性有症状性深静脉血栓患者口服Xa因子直接抑制剂BAY 59-7939)研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第11期3卷 42-43页

作者： Agnelli G. gallus A. Goldhaber S.Z. 孙凯 Division of Internal and Cardiovascular Medicine University of Perugia Ospedale S. Maria Della Misericordia Perugia Italy Dr.

背景:在对需长期抗凝治疗疾病的处理中,迫切需要一种不必接受监测以调整剂量的安全有效的口服抗凝药。Rivaroxaban(BAY 59-7939)是一种目前正处于临床开发阶段的口服Xa因子直接抑制剂。方法和结果:在近端深静脉血栓患者中进行此项随机。

关键词：深静脉血栓 Xa rivaroxaban 近端抑制剂浮选药剂口服患者

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Fondaparinux用于预防老年急症内科患者静脉血栓栓塞的有效性和安全性:一项随机、安慰剂对照试验

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世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 2-3页

作者： Cohen A.T. Davidson B.L. gallus A.S. 杜媛 Department of Surgery Guy's King's and St. Thomas'School of Medicine London SE5 9PJ United Kingdom

Objective: To determine the efficacy and safety of the anticoagulant fondaparinux in older acute medical inpatients at moderate to high risk of venous thromboembolism. Design: Double blind randomised placebo controlled trial. Setting: 35 centres in eight countries. Participants: 849 medical patients aged 60 or more admitted to hospital for congestive heart failure, acute respiratory illness in the presence of chronic lung disease, or acute infectious or inflammatory disease and expected to remain in bed for at least four days. Interventions: 2.5 mg fondaparinux or placebo subcutaneously once daily for six to 14 days. Outcome measure: The primary efficacy outcome was venous thromboembolism detected by routine bilateral venography along with symptomatic venous thromboembolism up to day 15. Secondary outcomes were bleeding and death. Patients were followed up at one month. Results: 425 patients in the fondaparinux group and 414 patients in the placebo group were evaluable for safety analysis(10 were not treated). 644 patients(75.9% ) were available for the primary efficacy analysis. Venous thrombembolism was detected in 5.6% (18/321) of patients treated with fondaparinux and 10.5% (34/323) of patients given placebo, a relative risk reduction of 46.7% (95% confidence interval 7.7% to 69.3% ). Symptomatic venous thromboembolism occurred in five patients in the placebo group and none in the fondaparinux group(P=0.029). Major bleeding occurred in one patient(0.2% ) in each group. At the end of follow- up, 14 patients in the fondaparinux group(3.3% ) and 25 in the placebo group(6.0% ) had died. Conclusion: Fondaparinux is effective in the prevention of asymptomatic and symptomatic venous thromboembolic events in older acute medical patients. The frequency of major bleeding was similar for both fondaparinux and placebo treated patients.

关键词：静脉血栓栓塞 Fondaparinux 安全性分析内科患者老年急症对照试验安慰剂 fondaparinux 随机内科住院患者

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阿哌沙班vs依诺肝素用于膝关节置换术后血栓预防(ADVANCE-2):随机双盲试验

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中华关节外科杂志（电子版） 2013年第1期7卷 94-102页

作者： Michael Rud Lassen Gary E Raskob Alexander gallus Graham Pineo Dalei Chen Philip Hornick Department of Orthopaedics Spine ClinicClinicalTrial UnitHersholm HospitalUniversity of CopenhagenHorsholmDenmark MD College of Public Health University of Oklahoma Health Sciences CentreOklahoma CityOKUSA PhD SA Pathology at Flinders Medical Centre and Flinders University AdelaideSAAustralia MD Department of Medicine and Oncology University of CalgaryCalgaryABCanada MD Research and Development Bristol-Myers SquibbPrincetonNJUSA PhD Research and Development Bristol-Myers SquibbPrincetonNJUSA MD

背景依诺肝素等低分子肝素是预防大关节置换术后静脉血栓形成的首选。阿哌沙班是一种口服活性的Xa因了抑制剂,在预防大关节置换术后静脉血栓形成方面可能有效,而且相对于依诺肝素来说,出血风险较低、用法也较简便。本研究评估选择性全... 详细信息

背景依诺肝素等低分子肝素是预防大关节置换术后静脉血栓形成的首选。阿哌沙班是一种口服活性的Xa因了抑制剂,在预防大关节置换术后静脉血栓形成方面可能有效,而且相对于依诺肝素来说,出血风险较低、用法也较简便。本研究评估选择性全膝关节置换术后卜述药物的有效性和安全性。方法 ADVANCE-2为多中心随机双盲Ⅲ期研究,选择性双侧或单侧全膝关节置换术患者通过交互式中心电话系统进行分组,随机接受阿哌沙班2.5mg每天2次口服(1528例)或依诺肝素40mg每天1次皮下注射(1529例)。随机化方案由Bristol-Myers Squibb随机中心生成,按研究中心和单侧或双侧手术分层,区组大小为4。研究者、患者、统计专家、评判者和指导委员会不知道患者分组情况。阿哌沙班于手术伤口闭合后10～12小时使用,依诺肝素于术前12小时使用;两药均持续用药10-14天,按照计划用药结束时行双侧顺行性静脉造影。主要终点是治疗期间无症状和有症状的深静脉血栓形成、非致死性肺栓塞和全因死亡的复合指标。统计学计划要求在检验阿哌沙班的优效性之前达到非劣效;非劣效检验对意向治疗患者进行分析。本研究在***备案,备案号NCT00452530。结果接受治疗的3057例患者(阿哌沙班组1528例、依诺肝素组1529例)中,1973例符合主要有效性分析的要求。阿哌沙班组976例和依诺肝素组997例中,报告主要终点的患者分别为147例(15%)和243例(24%)[相对危险度0.62(95%可信区间CI为:0.51-0.74),P<0.0001;绝对危险度下降9.3%(5.8～12.7)]。阿哌沙班组1501例和依诺肝素组1508例中,发生大出血或临床相关非大出血的患者分别为53例(4%)和72例(5%)(P=0.09)。解读全膝关节置换术后次日上午使用阿哌沙班2.5mg每天2次,是依诺肝素40mg/天简便而更有效的口服替代措施,且不会增加出血。

关键词：全膝关节置换术随机双盲试验依诺肝素血栓预防术后深静脉血栓形成顺行性静脉造影 VS

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旅行与静脉血栓形成

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世界医学杂志 2003年第24期7卷 76-80页

作者： AlexanderS．gallus DouglasC．Goghlan 李文兵俞森洋不详 DepartmentofHematology FlindersMedicalCenterBedfordParkSA5042Australia

关于旅行或者何种强度的旅行容易导致静脉血栓形成及肺栓塞一直存在争议。几乎可以肯定，最近的新闻报道都明显夸大了二者的相关程度。众多病例对照研究的结论不一，在静脉血栓栓塞(venous thromtmembolism，VTE)病人中，有些研究发现... 详细信息

关于旅行或者何种强度的旅行容易导致静脉血栓形成及肺栓塞一直存在争议。几乎可以肯定，最近的新闻报道都明显夸大了二者的相关程度。众多病例对照研究的结论不一，在静脉血栓栓塞(venous thromtmembolism，VTE)病人中，有些研究发现并不存在过高比例的近期旅行史，而另有些研究却报道该比例高了2～4倍。长时间航空旅行易致血栓的最有力的证据来自那些在飞机着陆后不久即发生PE的病人的旅行史。两项独立分析研究提示：旅行时间超过6h，早期栓塞发生的风险随旅行时间延长呈指数级增长，旅行超过12h，20万分之一的乘客可能发生栓塞。最可能的解释为长时间静坐不动引起静脉血流淤滞，以及有证据(初步的和有争议的)显示，弹力袜能预防长距离旅行者发生深静脉血栓。目前迫切需要更多及更合理的研究来明确旅行相关血栓的绝对风险及可能导致血栓形成的个体的危险因素。缺乏这些依据，就很难给那些计划去旅行或考虑毖须放弃旅行的人以合理的解释。病例报道提示，多数旅行相关的血栓发生于既往有血栓史、近期外伤史或有其他易患因素的人群。针对这些危险人群提出危险警告及预防方法是更合理的，除非有正式的研究证实还存在其他一些风险因素。

关键词：旅行静脉血栓形成肺栓塞危险因素

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口服Ⅹa因子直接抑制剂阿哌沙班预防全膝关节置换术后患者血栓形成的效果和安全性

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中华关节外科杂志（电子版） 2013年第4期7卷 98-102页

作者： M.R.LASSEN B.L.DAVIDSON A.gallus G.PINEO J.ANSELL D.DEITCHMAN 杨言菊 Department of Orthopaedics and Clinical Trial Unit Nordsjaellands Hospital HoersholmUniversity of CopenhagenHoersholmDenmark Pulmonary-Critical Care Medicine Division University of Washington School of MedicineSeattleWAUSA Department of Haematology Flinders Medical Centre and Flinders UniversityAdelaideAustralia Department of Medicine and Oncology University of CalgaryCalgaryAlbertaCanada Department of Medicine Boston Medical CenterBostonMAUSA Research and Development Bristol-Myers SquibbPrincetonNJUSA 康腾特医药信息咨询(上海)有限公司

目的肝素和华法林是外科手术中预防静脉血栓栓塞症（venous thromboembolism，VTE）的常用药物。抑制Xa因子（factorXa，FXa）系基于一种特异性的抗凝机制，为改善效益风险比提供了可能。方法评估FXa的口服强效直接抑制剂阿哌沙班在全... 详细信息

目的肝素和华法林是外科手术中预防静脉血栓栓塞症（venous thromboembolism，VTE）的常用药物。抑制Xa因子（factorXa，FXa）系基于一种特异性的抗凝机制，为改善效益风险比提供了可能。方法评估FXa的口服强效直接抑制剂阿哌沙班在全膝关节置换（total knee replacement，TKR）术后患者中的疗效和安全性，并研究其剂量一反应关系。患者／方法1238例患者随机分配至6个不同剂量的双盲阿哌沙班组[5、10或20rog／d，分别按每日1次（QD）或每日2次（BID）给药]、依诺肝素组（30mgBID）或开放标签的华法林组[剂量滴定至国际标准化比值（International Normalized Ratio，INR）1．8～3．0]。治疗持续lO～14d，术后12～24h开始应用阿哌沙班或依诺肝素治疗，华法林组于手术当晚以华法林治疗。主要疗效结局指标为治疗期间VTE（静脉造影）和全因死亡的复合终点，主要安全性结局指标是严重出血事件。结果共1217例患者可进行安全性分析，856例患者可进行疗效分析。所有阿哌沙班组患者的疗效终点事件发生率均低于对照组。随着阿哌沙班剂量的增加，主要终点事件发生率降低（QD／BID组联合分析P=0．09；QD组P=0．19；BID组P=0．13）。无论在QD组（P=0．01）还是BID组（P=0．02），总出血事件发生率均表现出随剂量上升的趋势；但QD组与BID组间差异无统计学意义。结论与现有的TKR术后标准治疗方案相比，阿哌沙班2．5mgBID或5mgQD方案的效益风险比较高。

关键词：抗血栓阿哌沙班 Xa因子抑制剂,口服抗凝剂预防,手术全膝关节置换术静脉血栓栓塞症

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