Prostatic abscesses are a rare clinical entity in current practice due to the widespread use of antibiotics. Management usually imposes a challenge to urologists that is due to the difficult diagnosis, as it may mimic other diseases of the lower urinary tract and the lack of guidelines for treatment. Prostate abscess (PA) usually develops in immunocompromised patients, including diabetic and HIV patients, as a consequence of acute bacterial prostatitis. The reason for the lack of guidelines as regards PA is that most of the published data in the literature are case reports due to the declining incidence of the disease today. We presented a male patient who was not foreknown with pathological or personal antecedents or a promiscuous lifestyle. He was hospitalized in the urology section with subfebrility and lumbar pain. His general condition changed rapidly within the span of a few hours, the patient entering septic shock without an etiology or a determined infection. After careful serial investigations, hemocultures (atypical germs) for IgM antibodies Chlamydia Pneumoniae were found in the serological complement fixation (cf) test. The patient responded well to empirically initiated antibiotic treatment upon admission to Intensive Care. Due to a favorable evolution, the patient was declared clinically healthy upon discharge. This was a rare case in medical literature of septic shock of initially unspecified etiology but which, upon thorough investigations and urological reevaluation, revealed a prostatic abscess with Chlamydia Pneumoniae, exteriorized through the urethra and highlighted through positive hemocultures only.
Background and Objectives: Antibiotics are the most frequently prescribed drugs in hospitals and their prescription is increased during pregnancy and labor. There are limited data about this issue, and the safe use of antibiotics in pregnancy and antibiotic resistance remains a concern. The aim of the study is to evaluate the use of antibiotics among pregnant women attending hospital for five years. Materials and Methods: Antibiotic consumption and treatment information of patients were retrospectively collected from a hospital software program and expressed as defined daily dose (DDD) according to the World Health Organization (WHO) methodology for inpatients between 2017 and 2021. We evaluated antibiotic prescription by name, classes, and Food and Drug Administration (FDA) categories. Results: Antibiotic consumption shows a decreasing trend between 2017 and 2019, but an increasing one between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic in each year, followed by cefixime, amoxicillin, metronidazole, cefuroxime, ampicillin, and ciprofloxacin. We noticed that first- and fourth-generation cephalosporins were not prescribed to these patients. A very small percentage of women in this study received antibiotics such as aminoglycosides; fluoroquinolones were generally contraindicated in the perinatal period. A large percentage of prescriptions were antibiotics classified as category B by the FDA. The most common infections that occurred in the perinatal period were those of the kidney and urinary tract in a higher number than in other studies. Conclusions: Our study shows that many classes of antibiotics used in perinatal women belong to category B antibiotics, the most prescribed being cephalosporins. Because of insufficient safety evidence and the potential for teratogenic effects on the fetus, restricted use among the category C and D antibiotic classes was seen and anticipated. Improving maternal health requires the involvement of healthcare experts in risk assessment and evaluation of existing data for appropriate antibiotic selection, dose, duration of medication, and monitoring.
Nurses in Intensive Care Units (ICU) may be exposed to considerable stress of work. High levels of stress in ICU nurses affect the quality of nursing and the quality of life at work. Determination of occupational stress levels, burnout syndrome and overall job satisfaction among ICU nurses. The research was conducted in Intensive Care Unit of Emergency Clinical County Hospital of Oradea, Romania. Data were collected from the questionnaires, 29 nurses (of the 35) were selected for this study. Professional stress factors have been assessed through Expanded Nurses Stress Scale (ENSS), burnout syndrome through Maslach Burnout Inventory-Human Services Survey (MBI-HSS), while overall job satisfaction was measured by a 7-step Likert scale. The highest levels of stress were associated with workload and conflicts with other health professionals, professional relationship between nurses have been described as the least stressful. About burnout levels: a high score for emotional exhaustion and depersonalization, and a low score for professional achievements. Professional satisfaction has reached an average level. The fidelity of the scales was verified by the Cronbach’s alfa coefficient: Expanded Nurses Stress Scale (ENSS) (0.98) and Maslach Burnout Inventory-Human Services Survey (MBI-HSS) (0.73).
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