Search

Background: The aim of this study was to compare the safety and effectiveness of monotherapy versus combination therapy for the treatment of infections caused by S. maltophilia. Methods: This retrospective, multicenter, cohort study included patients treated with either monotherapy or combination therapy for infections caused by S. maltophilia. Primary outcomes included overall in-hospital mortality, 30-day mortality, and clinical cure. Safety outcomes were also evaluated. Multivariable logistic regression was used as a control for confounding variables. Results: A total of 407 patients were included, 330 patients received monotherapy and 77 patients received combination therapy. A total of 21% presented with concomitant bacteremia. After adjusting the differences between the two groups, there were no statistically significant differences between patients who received monotherapy versus combination therapy in clinical cure (55% vs 65%; OR, 0.72; 95% CI, 0.40–1.31) and overall in-hospital mortality (52% vs 49%; OR, 0.84; 95% CI, 0.45–1.57). However, patients who received monotherapy had a lower rate of 30-day mortality (28% vs 32%; OR, 0.45; 95% CI, 0.22–0.90) and acute kidney injury (9% vs 18%; OR, 0.35; 95% CI, 0.16–0.78). Conclusion: Clinical outcomes did not significantly differ in patients who received combination therapy versus monotherapy. More data are needed to validate these findings. [ABSTRACT FROM AUTHOR]

The global impact of COVID‐19 heightened existential awareness particularly among parents. This period provided a unique opportunity to implement the circle of security program, equipping parents to address parental stress, anxiety, and depression. Conducted with mothers in Saudi Arabia ranging in age from 19 to 30 years, this quasi‐experimental intervention study demonstrated a notable reduction in negative emotions, coupled with enhanced parent–child relationships and a strengthened sense of purpose in parenting. A total of 70 (55%) mothers attended at least 6 of 8 sessions, the criteria for completer status. After the intervention, there was a significant improvement in mental health, as the majority of participants fell within the normal ranges for anxiety (91.4%), depression (95.7%), and stress (95.7%). Furthermore, statistical evaluations provided strong evidence of the intervention's success, demonstrating a significant reduction in mean anxiety scores from 4.44 ± 3.88 to 2.8 ± 2.01 (p = 0.08), depression scores from 6.2 ± 5.0 to 3.54 ± 2.5 (p < 0.001), and stress scores from 9.29 ± 4.45 to 4.9 ± 4.5 (p < 0.001). These findings underscore the importance of interventions supporting parents during challenging times, such as a global pandemic. [ABSTRACT FROM AUTHOR]

Apixaban and rivaroxaban require lead-in dosing for 7 and 21 days, respectively, when treating venous thromboembolism (VTE). However, no evidence exists to support subtracting parenteral anticoagulation days from total lead-in dosing. A multicenter study was conducted, including adult patients with acute VTE who received apixaban or rivaroxaban. The patients were grouped as follows. The recommended group received oral lead-in anticoagulant for the full recommended duration. The mixed group received lead-in therapy as parenteral with oral anticoagulant. The incidence of recurrent VTE (rVTE) and major bleeding (MB) within 90 days were the main outcomes. Of the 368 included patients, 47.8% received apixaban, and 52.2% received rivaroxaban. The recommended lead-in was used in 296 patients (80.4%), whereas 72 (19.6%) received the mixed-lead-in regimen. Five patients had rVTE events within 90 days; two occurred during hospitalization in the recommended group versus none in the mixed group (0.7% vs. 0.0%; p = 1.000). After discharge, two events occurred in the recommended group and one in the mixed group (0.7% vs. 1.4%; p = 0.481). In terms of MB, 24 events occurred in 21 patients within 90 days. During hospitalization, 11 events occurred in the recommended group and seven in the mixed group (3.7% vs. 9.7%; p = 0.060). After discharge, five more events occurred in the recommended group and one in the mixed group (1.4% vs. 1.7%; p = 1.000). The mixed-lead-in regimen is safe and effective in comparison with the recommended-lead-in regimen. [ABSTRACT FROM AUTHOR]