This phase 3 trial in acute bacterial skin and skin structure infections showed IV followed by oral delafloxacin to be noninferior to IV vancomycin/aztreonam combination therapy and well tolerated. Oral delafloxacin appears to maintain the initial response with IV delafloxacin.

Tigecycline is safe and effective in hospitalized patients with serious infection caused by MRSA. There were too few cases of VRE to draw any conclusions.

Background: Stress associated with learning of a psychomotor task can influence the trainees learning ability. Surgical simulation is a validated training milieu designed to replicate real-life situations, prevent biases and provide objective metrics. However, the complexity of stress mechanisms and the absence of a reliable detection method make stress estimation difficult to quantify and to interpret. Aim: a) To assess the feasibility of a new watch-sized device to noninvasively measure stress parameters in novices during a simulation task and b) to compare its derived cardiac stress parameters to those of an ambulatory Holter monitor. Materials and methods: Twenty-one novices were trained on a basic skills module. During base line, exercise, and recovery phases, all subjects wore a wearable device and data regarding blood volume pressure, heart rate, inter beat interval, electrodermal activity, and skin temperature were recorded. Additionally, Holter Monitoring was used to concomitantly capture heart rate, R-R intervals and heart rate variability. Before and after each experiment, all subjects completed the short, six-item STAI scale. Results: Data analysis showed: a) when compared to STAI, electrodermal activity exhibited the best correlation, sensitivity and specificity and b) the device derived cardiac parameters highly correlated with the reciprocal Holter values during all experiment phases. Conclusion: This wearable device is an easy to use and well accepted by the participants noninvasive tool, which can provide accurate stress estimation in our simulation setting. Additionally, it can replicate Holter derived stress related heart parameters, thus eliminating the need to wear a rather cumbersome device.

Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Although CRC has been comprehensively characterized at the molecular level, the tumor heterogeneity hinders the identification of reliable diagnostic, prognostic and predictive biomarkers. Molecular stratification of CRC is based on prevalent gene mutations and transcription profiles but its significance for clinical practice remains obscure. Indeed, activating mutations in the genes KRAS, NRAS and BRAF are the only predictive biomarkers for anti-EGFR antibody therapy routinely tested the clinic for advanced stages of CRC. Gene expression signatures are important for clarifying the molecular mechanisms of CRC development and progression, but only two such tests for predicting recurrence risk are commercially available. The aim of our study was to propose a diagnostic approach based on mutation and gene expression analysis that can be routinely applied in the clinic for defining the most appropriate treatment strategy for each patient. We used qPCR to determine the presence of KRAS mutations and measure the transcription levels of a panel of 26 genes in 24 CRC patients. Statistical analyses were applied to check for associations between clinico-pathological and molecular parameters. Our results reveal novel data concerning CRC carcinogenesis: almost universal downregulation of EGFR; differential role of the pro-inflammatory cytokines TNF-α and IL-6; overexpression of the vitamin B12 transporter transcobalamin 1; tumor-suppressor function of SETD2, CA7 and GUCA2B. The practical application of these findings has yet to be clarified.

Introduction: Papillary thyroid cancer is the most common thyroid malignancy. Lymph nodes involvement is common in differentiated thyroid cancer, and cervical lymph node micrometastases are observed in up to 85% of patients with papillary thyroid cancer during surgery. While the therapeutic central lymph node dissection has been accepted, the debate on the prophylactic in differentiated thyroid carcinoma (DTC) continues. Aim: To evaluate the benefits and risk of prophylactic central lymph node dissection in differentiated thyroid cancer. Materials and methods: Between January 2014 and December 2018, 223 total thyroidectomies due to papillary thyroid cancer were performed in the Kaspela University Hospital in Plovdiv. The patients were allocated into two groups: group A consisting of 36 patients with total thyroidectomy alone, and group B - 178 patients with total thyroidectomy and prophylactic central lymph node dissection. Results: In 36 (21.6%) patients, we found metastases only in ipsilateral side. In 24 (13.4%) of them we found metastatic spread in both ipsilateral and contralateral lymph nodes. In 7 (3.9%) patients, the metastasis was found only in the contralateral nodes. A pre-laryngeal lymph node was found and removed in 79 patients. Metastases were found in 12 of these 79 nodes. Analysis of complications showed no significant differences in its rate in patients with TT+ PCLND vs. patients with TT alone. Conclusions: The present study suggests that the realization of total thyroidectomy with prophylactic central lymph node dissection in papillary thyroid cancer patients has neither substantial advantages nor significant complications for the short period of observation.