Infection outcome evaluation

In support of this, several recent studies have evaluated the clinical outcomes observed in flavivirus-infected patients that carry the CCR5A32 allele. One group... 

Barlow GD, Lamping DL, Davey PG, et al. Evaluation of outcomes in community-acquired pneumonia A guide for patients, physicians, and policymakers. Lancet Infect Dis 2003 3 476-488. 

Luna CM, Blanzaco D, Niederman MS, et al. Resolution of ventilator-associated pneumonia Prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome. Crit Care Med 2003 31 676-682. 

Although many clinical studies have been performed evaluating antibiotics for ABRS, no randomized, double-blind, placebo-controlled studies have used pre- and posttreatment sinus aspirate cultures as an outcome measure. Despite this, antibiotics appear to resolve symptoms more quickly and reduce failure rates and complications compared with no treatment.35-37 Since diagnosis usually is based on clinical presentation and not sinus aspirate cultures, clinicians must attempt to differentiate ABRS from viral rhinosinusitis. Therefore, it is important to limit antibiotic use to cases where infection is unlikely to resolve without causing prolonged disease patients with mild to moderate symptoms that persist for 10 days or worsen over 5 to 7 days and patients with severe symptoms,31,34... 

Many studies have been conducted evaluating or comparing the effectiveness of antimicrobials for treatment of intraabdominal infections. Substantial differences in patient outcomes from treatment with a variety of agents generally have not been demonstrated. 

If symptoms do not improve, the patient should be evaluated for persistent infection. There are many reasons for poor patient outcome with intraabdominal infection improper antimicrobial selection is only one. The patient maybe immunocompromised, which decreases the likelihood of successful outcome with any regimen. It is impossible for antimicrobials to compensate for a nonfunctioning immune system. There may be surgical reasons for poor patient outcome. Failure to identify all intraabdominal foci of infection or leaks from a GI anastomosis may cause continued intraabdominal infection. Even when intraabdominal infection is controlled, accompanying organ system failure, most often renal or respiratory, may lead to patient demise. 

The outcome from intraabdominal infection is not determined solely by what transpires in the abdomen. Unsatisfactory outcomes in patients with intraabdominal infections may result from complications that arise in other organ systems. A complication commonly associated with mortality after intraabdominal infection is pneumonia.26 A high APACHE (Acute Physiology And Chronic Health Evaluation) II score, a low serum albumin, and a high New York Heart Association cardiac function status were significantly and independently associated with increased mortality from intraabdominal infection.27... 

Clinical evaluation entailed administration to 45 MPS I patients in a randomized, placebo-controlled clinical trial. The primary efficacy outcomes assessed were forced vital capacity and distance walked in 6 min, both of which were statistically higher relative to placebo after 26 weeks of treatment. The most serious adverse reaction noted was that of a severe anaphylactic reaction in one patient. The most common adverse effects reported were respiratory tract infection, rash and injection-site reactions. The product is manufactured by BioMarin Inc. and is distributed by Genzyme Corporation. 

Echinacea is most often used to enhance immune function in individuals who have colds and other respiratory tract infections. Systematic reviews and cold treatment trials generally report favorable results for Echinacea in reducing symptoms or time to recovery if the agent was administered within the first 24 hours of a cold. To date, however, most of these trials have contained multiple variables (eg, formulation, dose, duration) that make it difficult to make a clear therapeutic recommendation or ensure reproducible outcomes. At best, symptoms and duration may be reduced by about 25-30%. Echinacea has also been evaluated as a prophylactic agent in the prevention of upper respiratory tract infection. These trials have generally been less favorable and have reported no effect. 

An amalgamation of these definitions may provide the best explanation of the concept of quality in health care. Each provides additional insight into quality, what we can expect from quality, and how quality can be perceived. Webster s definition supports the idea that quality is a continuum of excellence or the lack thereof. From the Office of Technology Assessment definition it can be said that in medical care, quality can be measured and used to evaluate the care delivered by health care providers. This definition also implies that the care offered to patients should increase the probability of positive outcomes (e.g., getting rid of an infection) and decrease negative outcomes of care (e.g.,... 

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