scholarly journals Reducing the dosing frequency of selective digestive tract decontamination to three times daily provides effective decontamination of Gram-negative bacteria

2021 ◽  
Author(s):  
Jara R. de la Court ◽  
Kim C. E. Sigaloff ◽  
Thomas Groot ◽  
Johan I. van der Spoel ◽  
Rogier P. Schade
Keyword(s):  
Clinical Outcome ◽  
Digestive Tract ◽  
Rank Test ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Log Rank Test ◽  
Significant Difference ◽  
Selective Digestive Tract Decontamination ◽  
Dosing Frequency ◽  
Before And After

AbstractThis study evaluated the effectiveness of selective digestive tract decontamination (SDD) application three times daily (t.i.d.) compared to the standard four times daily (q.i.d.). Retrospective equivalence (combined non-inferiority and non-superiority design) study with a before-and-after design on a tertiary ICU in which the SDD frequency was reduced from q.i.d. to t.i.d. All patients with ICU admissions ≥72h and with ≥2 surveillance cultures collected on different dates were included in this study. We compared successful decontamination of Gram-negative bacteria (GNB). Furthermore, time to decontamination, ICU-acquired GNB bacteraemia and 28-day mortality were compared between the two groups. In total 1958 ICU admissions (1236 q.i.d., 722 t.i.d). Decontamination was achieved during the first week of admission in 77% and 76% of patients receiving SDD q.i.d and t.i.d., respectively. Successful decontamination within 14 days (without consecutive acquisition of Gram-negative bacteria) was achieved in 69.3% of the admissions with q.i.d. versus 66.8% in t.i.d. SDD (p-value = 0.2519). The proportions of successful decontamination of GNB were equivalent in both groups (−0.025, 98% CI: −0.087; 0.037). There was no significant difference in time to decontamination between the two regimens (log-rank test p-value = 0.55). Incidence (episodes/1000 days) of ICU-acquired GNB bacteraemia was 0.9 in both groups, and OR for death at day 28 in the t.i.d. group compared to the q.i.d. group was 0.99 (95% confidence interval, 0.80–1.21). This study shows that a t.i.d. application regimen achieves similar outcomes to the standard q.i.d. regime, for both microbiological and clinical outcome measures.

scholarly journals Reducing the Dosing Frequency of Selective Digestive Tract Decontamination to Three Times Daily Provides Effective Decontamination of Potentially Pathogenic Micro-Organisms

2021 ◽  
Author(s):  
Jara Rebekka de la Court ◽  
Kim C.E. Sigaloff ◽  
Thomas Groot ◽  
Johan I. van der Spoel ◽  
Rogier P. Schade
Keyword(s):  
Digestive Tract ◽  
Rank Test ◽  
P Value ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Log Rank Test ◽  
Significant Difference ◽  
Selective Digestive Tract Decontamination ◽  
Before And After ◽  
Micro Organisms

Abstract PurposeThis study evaluated the effectiveness of selective digestive tract decontamination (SDD) application three times daily (t.i.d.) compared to the standard four times daily (q.i.d.).MethodsRetrospective equivalence study with a before-and-after design on a tertiary ICU in which the SDD frequency was reduced from q.i.d. to t.i.d. All patients with ICU admissions ≥72h, and with ≥2 surveillance cultures collected on different dates were included in this study. We compared successful decontamination of Gram-negative bacteria (GNB). Furthermore, time to decontamination, ICU-acquired GNB bacteraemia and 28-day mortality were compared between the two groups. ResultsIn total 1958 ICU admissions (1236 q.i.d., 722 t.i.d). Decontamination was achieved during the first week of admission in 77% and 76% of patients receiving SDD q.i.d and t.i.d., respectively. Successful decontamination within 14 days (without consecutive acquisition of Gram-negative bacteria) was achieved in 69.3.% of the admissions with q.i.d. versus 66.8% in t.i.d. SDD (p-value = 0.2519). The proportions of successful decontamination of GNB were equivalent in both groups (-0.025, 98% CI: -0.087; 0.037). There was no significant difference in time to decontamination between the two regimens (log-rank test p-value = 0.55). Incidence (episodes/1000 days) of ICU-acquired GNB bacteraemia was 0.9 in both groups and OR for death at day 28 in the t.i.d. group compared to the q.i.d. group was 0.99 (95% confidence interval, 0.80-1.21). ConclusionsThis study shows that a t.i.d. application regimen provides equally effective SDD compared to the standard q.i.d. regime, for both microbiological and clinical outcome measures.

PERBEDAAN FINANCIAL PERFORMANCE PASCA SECONDARY OFFERINGS

Wahana ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 41-49
Author(s):  
Djaja Perdana ◽  
Herbowo Herbowo
Keyword(s):  
Financial Performance ◽  
Stock Exchange ◽  
Hypothesis Test ◽  
Poor Performance ◽  
Rank Test ◽  
Growth Ratio ◽  
Significant Difference ◽  
Before And After ◽  
Signed Rank Test ◽  
Asset Turnover

This study aims to examine the differences in corporate financial performance before and after secondary offerings. The financial performance is proxied by WCR, DER, Solvency, ROA, ROE, Asset Turnover (ATO) and Growth ratio which representing the value of liquidity, financing, activity, performance and growth of the firm. The study involved 67 samples of the companies listed on the Indonesia Stock Exchange conducting secondary offerings during 2008-2013 period and selected through purposive random sampling method and using Financial Statement data from 2005-2016 period. Hypothesis test is performed using Wilcoxon Signed Rank test. The results of this study indicate that there is no significant difference in the ratio of Solvency, ROA and ROE between before and after secondary offerings, but there are significant differences in the ratio of WCR, DER, Asset Turnover and Growth. WCR ratio after secondary offerings increased, while DER ratio after secondary offerings decreased, the condition of both ratios showed better performance. While the indication of poor performance seen in decreasing asset turnover ratio and growth ratio.Keywords : agency theory, financial performance, secondary offerings

scholarly journals Pyelonephritis in Pediatric Uropathic Patients: Differences from Community-Acquired Ones and Therapeutic Protocol Considerations. A 10-Year Single-Center Retrospective Study

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 436
Author(s):  
Giovanni Parente ◽  
Tommaso Gargano ◽  
Stefania Pavia ◽  
Chiara Cordola ◽  
Marzia Vastano ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Retrospective Study ◽  
Success Rate ◽  
Pediatric Population ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Significant Difference ◽  
Klebsiella Spp

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020. We recorded 58 PNs in 33 patients affected by VUR and 112 PNs in the not VUR group. The mean age of not VUR patients at the PN episode was 1.3 ± 2.6 years (range: 20 days of life–3 years), and almost all the urine cultures, 111 (99.1%), isolated Gram-negative bacteria and rarely, 1 (0.9%), Gram-positive bacteria. The Gram-negative uropathogens isolated were Escherichia coli (97%), Proteus mirabilis (2%), and Klebsiella spp. (1%). The only Gram-positive bacteria isolated was an Enterococcus faecalis. As regards the antibiograms, 96% of not VUR PNs responded to beta-lactams, 99% to aminoglycosides, and 80% to sulfonamides. For the VUR group, mean age was 3.0 years ± 3.0 years (range: 9 days of life–11 years) and mean number of episodes per patient was 2.0 ± 1.0 (range: 1–5); 83% of PNs were by Gram-negatives bacteria vs. 17% by Gram-positive: the most important Gram-negative bacteria were Pseudomonas aeruginosa (44%), Escherichia coli (27%), and Klebsiella spp. (12%), while Enterococcus spp. determined 90% of Gram-positive UTIs. Regimen ampicillin/ceftazidime (success rate: 72.0%) was compared to ampicillin/amikacin (success rate of 83.0%): no statistically significant difference was found (p = 0.09). The pathogens of PNs in uropathic patients are different from those of community-acquired PNs, and clinicians should be aware of their peculiar antibiotic susceptibility. An empiric therapy based on the association ampicillin + ceftazidime is therefore suggested.

scholarly journals Clinical evaluation of the failure rate of metallic brackets bonded with orthodontic composites

2012 ◽  
Vol 23 (4) ◽  
pp. 399-402 ◽  
Author(s):  
Fábio Lourenço Romano ◽  
Rodrigo Alexandre Valério ◽  
Jaciara Miranda Gomes-Silva ◽  
José Tarcísio Lima Ferreira ◽  
Gisele Faria ◽  
...  
Keyword(s):  
Failure Rate ◽  
Orthodontic Treatment ◽  
Color Change ◽  
Rank Test ◽  
Initial Alignment ◽  
Bond Failure ◽  
Log Rank Test ◽  
Significant Difference ◽  
Mandibular Teeth

The purpose of the present study was to evaluate in vivo the failure rate of metallic brackets bonded with two orthodontic composites. Nineteen patients with ages ranging from 10.5 to 38.7 years needing corrective orthodontic treatment were selected for study. The enamel surfaces from second premolars to second premolars were treated with Transbond Plus-Self Etching Primer (3M Unitek). Next, 380 orthodontic brackets were bonded on maxillary and mandibular teeth, as follows: 190 with Transbond XT composite (3M Unitek) (control) and 190 with Transbond Plus Color Change (3M Unitek) (experimental) in contralateral quadrants. The bonded brackets were light cured for 40 s, and initial alignment archwires were inserted. Bond failure rates were recorded over a six-month period. At the end of the evaluation, six bond failures occurred, three for each composite. Kaplan-Meyer method and log-rank test (Mantel-Cox) was used for statistical analysis, and no statistically significant difference was found between the materials (p=0.999). Both Transbond XT and Transbond Plus Color Change composites had low debonding rates over the study period.

scholarly journals Analysis of Indonesian Islamic and Conventional Banking Before and After 2008

2016 ◽  
Vol 8 (11) ◽  
pp. 193 ◽  
Author(s):  
Arfianti Novita Anwar
Keyword(s):  
Secondary Data ◽  
Rank Test ◽  
Islamic Banking ◽  
Positive Contribution ◽  
Islamic Banks ◽  
Significant Difference ◽  
Before And After ◽  
Signed Rank Test ◽  
The Law ◽  
Conventional Banks

<p>This study aims to analyze the performance of Islamic banks and conventional banks before and after the implementation of Islamic Banking Act 2008. The performance will be measured using CAMEL ratio selected. This research is considered essential in examining the positive contribution of the application of the Act to improve the performance of Islamic banks in Indonesia. By using secondary data, this study compared the performance of Islamic banks with that conventional bank selected as samples during the study period. Data were analyzed using the Wilcoxon Signed Rank Test for inter-temporal and Mann-Whitney test for inter-bank. Inter-temporal Tests conducted on Islamic Banking showed that a significant difference was only seen in the NPF ratio of 2 years before and after implementation of Islamic Banking Act. As for conventional banks showed a more diverse ie for 1 year before and after the application of the Law on Islamic Banking there are significant differences for the ROA and ROE, two years before and after implementation of the Law Islamic banking there are significant differences for the CAR, ROA, ROE and NIM and for the overall test a significant difference to CAR, ROA, ROE, NIM and efficiency. Inter-bank testing showed that prior to the application of Islamic Banking Act there are significant differences between conventional banks and Islamic banks to CAR, ROA and efficiency. Furthermore, after the application of Islamic Banking Act there is a significant difference for the CAR and LDR / FDR.</p>

Effectiveness of the Bactiseal Universal Shunt for reducing shunt infection in a sub-Saharan African context: a retrospective cohort study in 160 Ugandan children

2014 ◽  
Vol 13 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Jordan D. Lane ◽  
John Mugamba ◽  
Peter Ssenyonga ◽  
Benjamin C. Warf
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Shunt Infection ◽  
Low Income Countries ◽  
Rank Test ◽  
Log Rank Test ◽  
Significant Difference ◽  
Chi Square Analysis

Object Antibiotic-impregnated shunts have yet to find widespread use in the developing world, largely due to cost. Given potential differences in the microbial spectrum, their effectiveness in preventing shunt infection for populations in low-income countries may differ and has not been demonstrated. This study is the first to compare the efficacy of a Bactiseal shunt system with a non–antibiotic-impregnated system in a developing country. Methods The Bactiseal Universal Shunt (BUS) was placed in 80 consecutive Ugandan children who required a shunt. In this retrospective cohort study, the outcome for that group was compared with the outcome for the immediately preceding 80 consecutive children in whom a Chhabra shunt had been placed. The primary end points were shunt failure, shunt infection, and death. Shunt survival was analyzed using the Kaplan-Meier method. Significance of differences between groups was tested using the log-rank test, chi-square analysis, Fisher's exact test, and t-test. Results There was no difference between groups in regard to age, sex, or etiology of hydrocephalus. Mean follow-up for cases of nonfailure was 7.6 months (median 7.8 months, interquartile range 6.5–9.5 months). There was no significant difference between groups for any end point. The BUS group had fewer infections (4 vs 11), but the difference was not significant (p = 0.086, log-rank test). Gram-positive cocci were the most common culturable pathogens in the Chhabra group, while the only positive culture in the BUS group was a gram-negative rod. Conclusions These results provide equipoise for a randomized controlled trial in the same population and this has been initiated. It is possible that the observed trends may become significant in a larger study. The more complex task will involve determining not only the efficacy, but also the cost-effectiveness of using antibiotic-impregnated shunt components in limited-resource settings.

scholarly journals Antibacterial Activity and Flavonoids Content of Artemisia cina Berg. ex Poljakov Ethyl Acetate Extracts

2021 ◽  
Vol 13 (1) ◽  
pp. 106-112
Author(s):  
Sri Kasmiyati ◽  
Elizabeth Betty Elok Kristiani ◽  
Maria Marina Herawati ◽  
Andreas Binar Aji Sukmana
Keyword(s):  
Antibacterial Activity ◽  
Medicinal Plant ◽  
Ethyl Acetate ◽  
Biological Activities ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Flavonoid Content ◽  
Gram Positive ◽  
Gram Negative ◽  
Significant Difference

The medicinal plant-derived bioactive compounds have a potential for many biological activities, including antimicrobial activity. Artemisia cina is a medicinal plant from the Compositae family with the potential of having antitumor, antifungal, and antibacterial activity. This study aimed to determine the antibacterial activity and the flavonoid content of A. Cina’s ethyl acetate extract. Plants samples were extracted by ethyl acetate maceration method. Antibacterial activity was tested against Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive bacteria (Bacillus subtilis and Staphylococcus aureus) by a disk diffusion method using 25, 50, and 100 mg/l extract concentrations. The flavonoid contents (quercetin and kaempferol) were measured using High-Performance Liquid Chromatography. The extracts of diploid and polyploid A. cina displayed some antibacterial activity, with the Gram-negative bacteria being more resistant than the Gram-positive counterpart. However, no significant difference was observed between the diploid and polyploid extracts. As for the flavonoid content, the highest quercetin content (0.5501 mg/ml) was found in the polyploid A. cina (J), while the highest kaempferol content (0.5818 mg/ml) was observed in the diploid A. cina (KJT). Although A. cina is widely grown in Indonesia, compared to other Artemisia species, A. cina has not been widely studied, especially its antibacterial  potential and in related to its flavonoid content and the use of ethyl acetate as the extraction solvent.  This study reveals the potential of A. cina as a natural antibacterial agent. 

scholarly journals Effectiveness of Picture Story Books Reading to Increase Kindness in Children Aged 5-6 Years

2018 ◽  
Vol 12 (1) ◽  
pp. 89 ◽  
Author(s):  
Giyati Retnowati ◽  
Rose Mini Agoes Salim ◽  
Airin Y Saleh
Keyword(s):  
Test Score ◽  
Measurement Instrument ◽  
Rank Test ◽  
Average Score ◽  
Storybook Reading ◽  
Signed Rank ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Signed Rank Test

This research aimed to determine the effectiveness of picture in storybook reading to increase kindness in children. This research involved 31 children aged 5-6 years; they were taken from the kindergarten in Bandung as the participants. The intervention was done by reading eight picture books in eight days. The kindness was measured using a measurement instrument created by the researcher, in the form of nine coloured cards that described the behaviour of kindness. The measurement was also done by seeing through the kindness tree and observation sheets that filled out by the teacher. The data analysis using the Wilcoxon Signed-rank test shows a significant difference in the average score of kindness (p<0,05) before and after picture storybook reading. Two weeks after the intervention, the improvement on all kindness behaviours with the post-test score is greater than pre-test score that still can be found. Observation through kindness tree and observational sheets shows the same result.

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