The HCV viral load was determined using an in-house real-time PCR

The HCV viral load was determined using an in-house real-time PCR assay targeting the 5′-NCR. Results: HCV subtypes 1b, 1a, and 3a were found in 45.5%, 32.0%, and 18.0% of the donors, respectively. The mean viral load of genotype 1 was significantly higher than that of the genotype 3 isolates. Subtype 1a was more frequent among young donors and 3a was more frequent among older donors. Protease inhibitor-resistant variants were detected in 12.8% of the sequenced samples belonging to genotype 1, and a higher frequency was observed among subtype 1a (20%) in comparison to 1b (8%). There was no difference in the prevalence of HCV risk factors among the genotypes or drug-resistant

variants. Conclusions: We found a predominance of subtype 1b, with an increase in the frequency of subtype 1a, in young subjects. Mutations conferring resistance to NS3 inhibitors were frequent in treatment-naive blood donors, particularly those ARS-1620 infected with subtype 1a. These variants were detected in the major viral population of HCV quasispecies, have replicative capacities comparable to nonresistant strains, and could be important for predicting

the response to antiviral triple therapy.”
“Objectives: The aim of this study was to compare the long-term results of 2 surgical strategies for patients with bilobar colorectal liver metastases (bCRLM). Background: Two-stage 3 hepatectomy is the surgical strategy mostly chosen for treating extensive BCLM with the pitfall of dropout after the first stage. One-stage strategy combining limited resections and radiofrequency ablation could be proposed GDC-0973 datasheet as an option in this population. Patients and Methods: Between 2000 and 2010, 272 patients were consecutively operated in 2 expert centers practicing 1- or 2-stage hepatectomy for bCRLM. A case-match study (1: 1) was conducted using number and size of nodules, synchronous presentation, primary node status, and extrahepatic disease

as matching variables to compare overall survival (OS) and disease-free survival (DFS). The analysis was performed in intention to treat, including patients who did not undergo the second stage. Results: In the case-match analysis (156 matched patients), median OS and DFSdid not differ significantly between patients in 1- and 2-stage hepatectomy, respectively: 37.2 and 34.5 months (P = 0.6), 9.4 and 7.5 months (P = 0.25). Multivariate analysis confirmed the absence of impact of strategy on OS and DFS. Primary advanced T stage and synchronous presentation were predictors of poor OS (HR = 3.67 and 1.92); CEA more than 200 ng/mL, absence of postoperative chemotherapy, and extrahepatic disease were predictive of recurrence (HR = 2.77, 1.85 and 1.69, respectively). Conclusions: This first case-match study demonstrates that on an intention-to-treat analysis 1- and 2-stage hepatectomy in patients with bCRLM achieve comparable OS and DFS, despite the high dropout of the 2-stage strategy.

001) Multivariate analysis revealed that tumor stage, nuclear gr

001). Multivariate analysis revealed that tumor stage, nuclear grade and Eg5 reactivity (P < 0.001, P = 0.002, P = 0.032) were identified Selleck Salubrinal as independent prognostic factors for recurrence-free survival in patients with RCC. In our opinion, the result of this study proved the relationship between Eg5 expression and worse clinical outcome in RCC. This finding suggested that Eg5 served as a prognostic factor, which could be useful to predict cancer evolution and provide appropriate treatments for RCC patients.”
“We present a case of 8 year-old boy with several episodes of ventricular fibrillation in the

course of tachycardia-mediated cardiomyopathy and severe decompensated heart failure. The cardiomyopathy was 3-Methyladenine clinical trial caused by incessant long-RP tachycardia that

was resistant to pharmacotherapy. Despite initial suspition that the arrhythmia was permanent junctional reciprocating tachycardia (PJRT) electrophysiology study revealed atypical atrioventricular nodal reentrant tachycardia. Due to clinical and electrocardiographical presentation mimicking PJRT such arrhythmia merits the name ‘pseudo PJRT’.”
“Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy C59 clinical trial and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients’ clinical condition.\n\nMethods : A total

of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures.\n\nResults : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The 432 cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p<0.0001).

Likewise, studies that identify moderators of treatment efficacy

Likewise, studies that identify moderators of treatment efficacy will assist clinicians in deciding how and for whom to prescribe exercise.”
“Pain after total knee arthroplasty (TKA) represents a common observation in about 20% of the patients after surgery. Some of these painful knees require early

revision surgery within 5 years. Obvious causes of failure might be identified with clinical examinations and standard radiographs only, whereas the unexplained painful TKA still remains a challenge for the surgeon. It is generally accepted that a clear understanding of the failure mechanism in each case is required BI 6727 mouse prior considering revision surgery. A practical 10-step diagnostic algorithm is described for failure analysis in more detail. The evaluation of a painful TKA includes an extended history, analysis of the type of pain, psychological exploration, thorough clinical examination including spine, hip and ankle, laboratory tests, joint aspiration and test infiltration, radiographic analysis and special imaging techniques. It is also important to enquire about the length and type of conservative therapy. Using this diagnostic algorithm, a sufficient failure analysis is possible in almost all patients with painful TKA.\n\nLevel of evidence

“During the past decade there has been an increasing recognition of the incidence of mild traumatic brain injury (mTBI) and a better understanding of the subtle neurological and cognitive deficits that may result from it. A substantial, albeit suboptimal,

effort AG-881 chemical structure has been made to define diagnostic criteria for mTBI and improve diagnostic accuracy. Thus, biomarkers that can accurately and objectively detect brain injury after mTBI and, ideally, aid in clinical NU7441 price management are needed. In this review, we discuss the current research on serum biomarkers for mTBI including their rationale and diagnostic performances. Sensitive and specific biomarkers reflecting brain injury can provide important information regarding TBI pathophysiology and serve as candidate markers for predicting abnormal computed tomography findings and/or the development of residual deficits in patients who sustain an mTBI. We also outline the roles of biomarkers in settings of specific interest including pediatric TBI, sports concussions and military injuries, and provide perspectives on the validation of such markers for use in the clinic. Finally, emerging proteomics-based strategies for identifying novel markers will be discussed.”
“Increasing evidences have suggested vascular endothelial 4 inflammatory processes are the initiator of atherosclerosis. Bestrophin 3 (Best-3) is involved in the regulation of cell proliferation, apoptosis and differentiation of a variety of physiological functions, but its function in cardiovascular system remains unclear. In this study, we investigated the effect of Best-3 on endothelial inflammation.

We developed a moderate-throughput in vitro model of C difficile

We developed a moderate-throughput in vitro model of C. difficile infection and used it to test competition between four ribotype 027

clinical isolates and clinical isolates of four other ribotypes (001, 002, 014, and 053). We found that ribotype 027 strains outcompeted the strains of other ribotypes. A similar competitive advantage was observed when two ribotype pairs were competed in a mouse model of C. difficile infection. Based upon these results, we #3 randurls[1|1|,|CHEM1|]# conclude that one possible mechanism through which ribotype 027 strains have caused outbreaks worldwide is their increased ability to compete in the presence of a complex microbiota.”
“Human pluripotent stem cell (hPSC) differentiation typically yields heterogeneous populations. Knowledge of signals controlling embryonic lineage bifurcations could efficiently yield desired cell types through exclusion of alternate fates. Therefore, we revisited signals driving induction and anterior-posterior patterning of definitive endoderm to generate a coherent roadmap for endoderm differentiation. With striking temporal dynamics, BMP and Wnt initially specified anterior primitive streak (progenitor to endoderm), yet, 24 hr later, suppressed

endoderm and induced mesoderm. At lineage bifurcations, cross-repressive signals separated mutually exclusive fates; TGF-beta and BMP/MAPK respectively induced pancreas versus liver from endoderm by suppressing the alternate lineage. We systematically blockaded alternate fates throughout multiple consecutive bifurcations, thereby this website efficiently differentiating multiple hPSC lines exclusively into endoderm and its derivatives. Comprehensive transcriptional and chromatin mapping of highly pure endodermal populations revealed that endodermal enhancers existed in a surprising diversity of “pre-enhancer” states before activation, reflecting the establishment of a permissive chromatin landscape as a prelude to differentiation.”
“Despite the accumulating knowledge of alterations in pancreatic cancer molecular pathways,

no substantial improvements in the clinical prognosis have been made and this malignancy continues Selleck Ulixertinib to be a leading cause of cancer death in the Western World. The orphan nuclear receptor COUP-TFII is a regulator of a wide range of biological processes and it may exert a pro-oncogenic role in cancer cells; interestingly, indirect evidences suggest that the receptor could be involved in pancreatic cancer. The aim of this study was to evaluate the expression of COUP-TFII in human pancreatic tumors and to unveil its role in the regulation of pancreatic tumor growth. We evaluated COUP-TFII expression by immunohistochemistry on primary samples. We analyzed the effect of the nuclear receptor silencing in human pancreatic cancer cells by means of shRNA expressing cell lines. We finally confirmed the in vitro results by in vivo experiments on nude mice.

The primary objective was to determine superiority of dulaglutide

The primary objective was to determine superiority of dulaglutide 1.5 mg versus placebo in HbA(1c) change at 26 weeks. RESEARCH DESIGN AND METHODS This 52-week, multicenter, parallel-arm study (primary end point: 26 weeks) randomized patients (2: 2: 2: 1) to dulaglutide 1.5 mg,

dulaglutide 0.75 mg, exenatide 10 mg, or placebo (placebo-controlled period: 26 weeks). Patients were treated with metformin (1,500-3,000 mg) and pioglitazone (30-45 mg). Mean baseline HbA(1c) was 8.1% (65 mmol/mol). RESULTS Least squares mean 6 SE HbA(1c) change from baseline to the primary end point was -1.51 +/- LY2090314 inhibitor 0.06% (-16.5 +/- 0.7 mmol/mol) for dulaglutide 1.5 mg, -1.30 +/- 0.06% (-14.2 +/- 0.7 mmol/mol) for dulaglutide 0.75 mg, -0.99 +/- 0.06% (-10.8 +/- 0.7 mmol/mol) for exenatide, and -0.46 +/- 0.08% (-5.0 +/- 0.9 mmol/mol) for placebo. Both dulaglutide doses were superior to placebo at 26 weeks (both adjusted one-sided P smaller than 0.001) and exenatide at 26 and 52 weeks (both adjusted one-sided P smaller than 0.001). Greater percentages of patients reached HbA(1c) targets with dulaglutide 1.5 mg and 0.75 mg than with placebo and exenatide (all P smaller than 0.001). At 26 and 52 click here weeks, total hypoglycemia incidence was lower in patients receiving dulaglutide 1.5 mg than in those receiving exenatide; no dulaglutide-treated patients reported severe hypoglycemia.

The most common gastrointestinal adverse events for dulaglutide were nausea, vomiting, and diarrhea. Events were mostly mild to moderate and transient. CONCLUSIONS Both once-weekly dulaglutide doses demonstrated superior glycemic control versus placebo and exenatide with an acceptable tolerability and safety profile.”
“Background: Hyperechogenicity of the substantia nigra (SN) measured by transcranial sonography (TCS) is a characteristic feature observed in patients with Parkinson’s disease (PD). To our knowledge, no SN hyperechogenicity

data are available for Polish population. Moreover most of studies come from few centres, which used the one type of ultrasound Selleckchem HKI-272 device. The main aim of the study was to investigate the association between PD and SN hyperechogenicity measured by sonographic machine, not assessed so far. Materials and methods: In this study cross-sectional study SN hyperechogenicity was evaluated in 102 PD patients and 95 control subjects. Midbrain was visualised by Aloka Prosound 7 ultrasound device. SN area measurement, the 4 relation to the clinical features of PD, inter- and intra-observer reliability were evaluated. Results: We confirmed that SN echogenicity is significantly increased in PD patients compared to control subjects (p smaller than 0.001). The area under curve for PD patients vs. controls was 0.93. Receiver operating characteristic analysis indicated a cut-offs for SN echogenicity at 0.19 cm(2) with accuracy equal to 90%, specificity – 86% and sensitivity – 93.7%. The SN hyperechogenicity was not related to PD clinical findings.

Methods and Results: Rats were

\n\nMethods and Results: Rats were check details injected with NaHS (an H2S donor, 2-200 mu, i.p.) or saline for 3 weeks. MBP was measured with a tail-cuff method. C erebral arterioles were isolated and cannulated

in an organ bath system, and vessel diameters were measured with an image-shearing device. Changes in diameter in response to stepwise increases in intravascular pressure (20-120 mmHg) were investigated under no-flow conditions. After the treatments, plasma H2S increased and MBP decreased significantly. NaHS reduced the myogenic response in a dose-dependent manner. This effect was markedly attenuated by glibenclamide, a K-ATP channel blocker. Blockade of nitric oxide (NO) production with NG-nitro-L-arginine methyl ester (L-NAME, a NO synthase inhibitor) enhanced,

whereas removal of the endothelium abolished the inhibitory role of NaHS on the myogenic response.\n\nConclusions: For the first time it has been demonstrated that H2S decreases the myogenic response of cerebral arterioles in vivo, and this effect is selleck endothelium-dependent and partially mediated by K-ATP channels. (Circ J 2012; 76: 1012 1019)”
“BACKGROUND & AIMS: Liver X receptors (LXRs) are transcriptional regulators of cholesterol metabolism, controlling cholesterol flow into cells, catabolism, and efflux. Cholesterol controls cell proliferation; disruptions in cholesterol metabolism have been associated with the development of colon cancer. We investigated whether expression of activated LXR protects against intestinal tumorigenesis in mice. METHODS: We analyzed the development of colon cancer in mice that express a constitutive active form of LXR alpha only in the intestinal epithelium, under the control of villin promoter (iVP16LXR alpha). These mice were crossed with adenomatous polyposis coli (Apc)(min/+) mice,

or given azoxymethane followed by dextran sodium sulfate, to assess intestinal tumor formation. We also assessed proliferation and apoptosis of a human ATPase inhibitor colorectal cancer cell line (HT29) transfected with an adenoviral vector that expressed Ad VP16hLXR alpha, compared with cells expressing AdVP16 (control), and their ability to form xenograft tumors in mice. HT29 cells also were incubated with the LXR ligand GW3965. RESULTS: In human colorectal cancer cells, ligand-induced activation of LXR or transfection with Ad VP16hLXR alpha blocked the G1 phase, increased caspase-dependent apoptosis, and slowed growth of xenograft tumors in mice. iVP16LXR alpha mice formed fewer, smaller tumors than VP16 (control) mice after administration of azoxymethane and dextran sodium sulfate. APC(min/+)/iVP16LXR alpha mice also developed fewer, smaller intestinal tumors than APC(min/+)/iVP16 mice.

(C) 2011 Elsevier Ireland Ltd All rights reserved “

(C) 2011 Elsevier Ireland Ltd. All rights reserved.”
“Biliary metabolites present at 6 h post-dose following a single oral dose of [C-14]-diclofenac (10 mg kg(-1)) to male

bile duct-cannulated C57BL/6 J mice were profiled and identified. Over the 6 h duration of the study similar to 19.5 % of the administered radioactivity was excreted into the bile as either [C-14]-diclofenac or metabolites. When profiled using HPLC with online radiodetection, the presence of at least 13 radiolabelled components was indicated. These compounds were shown, by consecutive reaction mass spectrometry, to comprise a range of hydroxylated metabolites conjugated Entinostat datasheet to either taurine, glucose and/or glucuronic acid. Both phenolic and acylglucuronide-containing metabolites were observed. ARS-1620 The confirmation of the presence of these glucuronide conjugates in mouse bile may have important consequences in the light of emerging theories concerning the role of bacterial glucuronidases for the GI-tract toxicity of NSAIDs such as diclofenac.”
“As one of the most important centers of origin for the genus 432 citrus L, China is rich in wild mandarin germplasm. In this study, phenolic compounds in the fruit pulps of 14 wild mandarins

(Citrus reticulate Blanco.) native to China were determined and their antioxidant capacities were evaluated by the DPPH, FRAP, ABTS, and ORAC methods. We found that Nieduyeju had the highest total phenolic MEK inhibitor content (22.26+/-0.64 mg/g DW), and Wangcangzhoupigan had the highest total flavonoid content (3.82+/-0.19 mg/g, DW). Hesperidin was the dominant flavonoid, and Guangxihongpisuanju (22.13+/-0.33 mg/g DW) was with the highest content of this flavonoid among the 14 samples studied. Ferulic acid was the most abundant phenolic acid, and Nieduyeju (2336.07+/-145.66 mu g/g, DW) was with the highest extractable ferulic acid, while Guangxihongpisuanju (170.28+/-5.03 mu g/g, DW) was with the highest bound ferulic acid. Additionally, the overall antioxidant potency composite

(APC) index showed obvious variations in the citrus fruits examined (52.26-88.73). The wild citrus fruits Nieduyeju, Wangcangzhoupigan and Guangxihongpisuanju presented significantly higher APC indices than the mandarin cultivars Satsuma and Ponkan (p smaller than 0.05). Overall, Nieduyeju, Guangxihongpisuanju, and Wangcangzhoupigan fruits pulps contained more phenolics and exhibited higher antioxidant capacities than the cultivars Satsuma and Ponkan, and were good sources of phytochemicals and natural antioxidants. (C) 2013 Elsevier B.V. All rights reserved.”
“BackgroundTissue factor pathway inhibitor- (TFPI) inhibits factorXa by forming a binary TFPI-FXa complex in a reaction that is stimulated by proteinS. TF-FVIIa forms a quaternary complex with TFPI and FXa, which shuts off the initiation of coagulation via the extrinsic pathway.

Results: Compared with control subjects, siblings showed incr

\n\nResults: Compared with control subjects, siblings showed increased activity within the amygdala, hippocampus, medial prefrontal cortex, posterior and anterior cingulate cortex, and middle temporal gyrus in response to emotionally arousing pictures relative to neutral EVP4593 mouse pictures. No activation differences between the groups were found during the neutral stimuli, indicating that the observed hyperactivity is likely caused by abnormal emotion processing

rather than impaired visuoattentional processing.\n\nConclusions: Our findings of hyperactivity in siblings during emotion processing suggest that functional abnormalities within the neural circuitry of emotion processing are related to the genetic risk for developing schizophrenia.”
“Purpose: In dialysis patients, longer survival is associated with a higher residual renal function. Randomized controlled trials are conducted to clarify how residual renal function can be preserved. However, existing methods for measuring residual renal function are uncertain and there is a need Fer-1 solubility dmso for establishing a standard for measurements of glomerular filtration rate (GFR) in dialysis patients. Methods: Cr-51-EDTA clearances in plasma, urine, and dialysate were evaluated in a sample of 12 hemodialysis and

12 peritoneal dialysis patients. The patients’ 3 condition was generally stable, and all patients were investigated twice within 4-10 days. Results: Plasma clearances of Cr-51-EDTA for all patients ranged between 2.1 and 30.8 mL/min/1.73m(2), whereas urinary Cr-51-EDTA clearances ranged from 0.7-20.0 mL/min/1.73m(2). This difference was statistically significant (p < 0.001). Week-to-week reproducibility expressed as coefficients of variation were below or equal to 10% for plasma clearances and 13% for urinary

clearances in hemodialysis patients and 14% in peritoneal dialysis patients. Conclusions: This study demonstrated a difference between Cr-51-EDTA plasma and urinary clearances in dialysis patients. Plasma clearance of Cr-51-EDTA had selleckchem the best reproducibility. For repeated measurements as in clinical prospective trials, we recommend Cr-51-EDTA plasma clearance based on blood sampling at 5 + 24 hours with subtraction of Cr-51-EDTA dialysate clearance in peritoneal dialysis patients. Further studies are needed to corroborate our findings.”
“Despite advances in treatments, lung cancer has been the leading cause of cancer-related deaths in the United States for the past several decades. Recent findings from the National Lung Screening Trial reveal that low-dose helical computed tomography (CT) scan screening of high-risk individuals reduces lung cancer mortality. This suggests that early detection is of key importance to improving patient outcome.

BACKGROUND Conduction disturbances are a frequent complication of

BACKGROUND Conduction disturbances are a frequent complication of transcatheter 3 aortic valve replacement. The rates of PPI in the published reports vary according to bioprosthesis type and the indications for PPI. METHODS The primary endpoint was the 30-day 3-MA purchase incidence of PPI with Class I/II indications when

the Medtronic CoreValve System was implanted at an optimal depth (# 6 mm below the aortic annulus). The timing and resolution of all new-onset conduction disturbances were analyzed. RESULTS A total of 194 patients were treated. The overall rate of PPI for Class I/II indications was 18.2%. An optimal depth was reached in 43.2% of patients, with a nonsignificantly lower incidence of PPI in patients with depths # 6 mm, compared with buy CAL-101 those with deeper implants (13.3% vs. 21.1%; p = 0.14). In a paired analysis, new-onset left bundle branch block and first-degree

atrioventricular block occurred in 45.4% and 39.0% of patients, respectively, and resolved spontaneously within 30 days in 43.2% and 73.9%, respectively. In patients with new PPI, the rate of intrinsic sinus rhythm increased from 25.9% at 7 days to 59.3% at 30 days (p = 0.004). CONCLUSIONS Optimal Medtronic CoreValve System deployment and adherence to international guidelines on cardiac pacing are associated with a lower rate of new PPI after transcatheter aortic valve replacement, compared with results reported in previous studies. (CoreValve Advance-II Study: Prospective International Post-Market Study [ADVANCE II]; NCT01624870) ( C) 2015 by the American College of Cardiology Foundation.”
“Complications of acute respiratory distress syndrome (ARDS) are common among critically ill patients infected with highly pathogenic influenza viruses. Macrophages and neutrophils

constitute the majority of cells recruited into infected lungs, and are associated with immunopathology in influenza pneumonia. We examined pathological manifestations in models VX-680 clinical trial of macrophage- or neutrophil-depleted mice challenged with sublethal doses of influenza A virus H1N1 strain PR8. Infected mice depleted of macrophages displayed excessive neutrophilic infiltration, alveolar damage, and increased viral load, later progressing into ARDS-like pathological signs with diffuse alveolar damage, pulmonary edema, hemorrhage, and hypoxemia. In contrast, neutrophil-depleted animals showed mild pathology in lungs. The brochoalveolar lavage fluid of infected macrophage-depleted mice exhibited elevated protein content, T1-alpha, thrombomodulin, matrix metalloproteinase-9, and myeloperoxidase activities indicating augmented alveolarcapillary damage, compared to neutrophil-depleted animals.

Other important outcomes such as quality of life, long-term patie

Other important outcomes such as quality of life, long-term patient outcomes and use of healthcare resources were not reported in these trials.\n\nOverall, 6.5% (39/602 participants, four trials) developed Selleck AZD1480 superficial surgical site infections. There was no significant difference between the groups in the proportion of participants who developed superficial surgical site infections (RR 0.73; 95% CI 0.40 to 1.33). A total of 23 participants (23/625 (3.7%), four trials) developed superficial wound dehiscence. Twenty-two of the 23 participants belonged

to the interrupted suture group. The proportion of participants who developed superficial wound dehiscence was statistically significantly lower in the continuous suture group compared to the interrupted suture group selleck kinase inhibitor (RR 0.08; 95% CI 0.02 to 0.35). Most of these wound dehiscences were reported in two recent trials in which the continuous skin suture groups received absorbable subcuticular sutures while the interrupted skin suture groups received non-absorbable transcutaneous sutures. The non-absorbable sutures were removed seven to nine days after surgery in the interrupted sutures groups

whilst sutures in the comparator groups were not removed, being absorbable. The continuous suture technique with absorbable suture does not require suture removal and provides support for the wound for a longer period of time. This may have contributed to the EGFR inhibitor difference between the two groups in the proportion of participants who developed superficial wound dehiscence. There was no significant difference in the length of the hospital stay between the two groups (MD -1.40 days; 95% CI -7.14 to 4.34).\n\nAuthors’ conclusions\n\nSuperficial wound dehiscence may be reduced by using continuous subcuticular sutures. However, there is uncertainty about this because of the quality of the evidence. Besides, the nature of the suture material used may have led to this observation, as the continuous suturing technique used suture material that did not need to be removed, whereas the comparator used interrupted (non-absorbable)

sutures that did need to be removed. Differences in the methods of skin closure have the potential to affect patient outcomes and use of healthcare resources. Further well-designed trials at low risk of bias are necessary to determine which type of suturing is better.”
“Background\n\nMortality rates among patients with sepsis, severe sepsis or septic shock ranges from 27% to 54%. Empirical broad-spectrum antimicrobial treatment is aimed at achieving adequate antimicrobial therapy and thus reducing mortality. However, there is a risk that empirical broad-spectrum antimicrobial treatment can expose patients to overuse of antimicrobials. De-escalation has been proposed as a strategy to replace empirical broad-spectrum antimicrobial treatment with a narrower antimicrobial therapy.