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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 | Myocardial infarction after noncardiac surgery显示文摘 | Badner NH Knill RL Brown JE | 1998 | Anesthesiology1998，88，： | 1 |
| 3 | MIC-1 serum level and genotype : associations with progress and prognosis of colorectal carcinoma显示文摘 | Brown DA Ward RL Buckhauhs P | 2003 | Clin Cancer Res2003，9，： | 1 |
| 4 | Role of oxidantstress inendothelial dys functionproducedbyexperimentalnemiainhuman s显示文摘 | Kanani PM Sinkey CA Browning RL | 1999 | Circulation1999，100，1： | 1 |
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| 7 | Comparing the clinical and economic effects of clinical examination,pulse oximetry,and echocardiography in newborn screening for congenital heart defects:a probabilistic cost-effectiveness model and value of information analysis显示文摘 | Griebsch I Knowles RL Brown J | | 0，，02： | 1 |
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| 9 | Subcellular post-transcriptional targeting:Delivery of an intracellular protein to the extracellular leaflet of the plasma membrane using a glycosyl-phosphatidylinositol (GPI) membrane anchor in neurons and polarised epithelial cells显示文摘 | Brown O Cowen RL Preston CM | 2000 | Gene Ther2000，7，22： | 1 |
| 10 | The glutamate-activated anion conductance in excitatory amino acid transporters is gated independently by the individual subunlts 显示文摘 | KOCH HP BROWN RL LARSSON HP | 2007 | J Neurosci2007，27，11： | 1 |
| 11 | Fluorodeoxyglucose uptake in human cancer cell lines is increased by hypoxia 显示文摘 | Clavo AC Brown RS Wahl RL | 1995 | J Nucl Med1995，36，9： | 1 |
| 12 | Iatrogenic endometriosis caused by uterine morcellation during a supracervical hysterectomy 显示文摘 | Brown RL Decenzo JA | 2004 | Obstet Gynecol2004，103，6： | 1 |
| 13 | Association of alcohol consumption and sleep disordered breathing in men and women显示文摘 | Peppard PE Austin D Brown RL | 2007 | J Clin Sleep Med2007，3，3： | 1 |
| 14 | Percutaneous transluminal angioplasty and stenting for carotid artery stenosis显示文摘 | Featherstone RL Brown MM | 2004 | Cochrane Database Syst Rev2004，，00： | 1 |
| 15 | The Effect of Glines Canyon Dam on Hydrochorous Seed Dispersal in the Elwha River 显示文摘 | Brown RL Chenoweth J | 2008 | Northwest Science2008，82，： | 1 |
| 16 | Serum marcrophage inhibitory eytokine - 1 ( MIC - 1 ) levels forthe diagnosis of prostate cancer显示文摘 | Brown DA Stephan C Ward RL | 2006 | Clinical Cancer Res2006，12，： | 1 |
| 17 | International carotid stenting study:protocol for a randoinised clinical trial comparing carotid stenting with endarterectomy in symptomatic carotid artery stenosis 显示文摘 | Featherstone RL Brown MM Coward ID | 2004 | Cerebrovasc Dis2004，18，1： | 1 |
| 18 | Role of oxidant stress in en-dothelial dysfunction produced by experimental hyperhomocyst inemia in humans显示文摘 | Kanani PM Sinkey CA Browning RL | 1999 | Circulation1999，100，： | 1 |
| 19 | Comparison of coronary revascularization procedures in octogenarians: asystematic review and meta-analysis显示文摘 | McKellar SH Brown ML Frye RL | 2008 | Nat Clin Pract Cardiovasc Med2008，5，11： | 1 |
| 20 | Serum ostceprotegerin levels are increased in patients with advanced prostate cancer显示文摘 | Brown JM Vessella RL Kostenuik PJ | 2001 | Clin Cancer Res2001，7，10： | 1 |
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