Optimization of antimicrobial therapy in vancomycin-resistant enterococcal bacteraemia using a rapid detection Gram-positive blood culture assay.

Rapid molecular blood culture Gram-positive (BC-GP) assay can promptly identify vancomycin-resistant enterococcal (VRE) bloodstream infections (BSIs). We sought to evaluate patients with VRE BSI following the pre (N = 44) and post (N = 20) implementation of Verigene BC-GP assay. The average time to detection of VRE was 25.9 ± 4.1h (95% confidence interval (CI): 17.6-34.1; P < 0.001) earlier with Verigene BC-GP assay. Compared to patients in the pre-Verigene BC-GP period, the mean adjusted difference in time to administration of anti-VRE therapy was 18.2 ± 7.8h (95% CI: 2.5-33.8; P = 0.024) earlier among patients in the post-Verigene BC-GP period.

Pharmacokinetic drug interactions of vinca alkaloids: summary of case reports.

Involvement of the cytochrome P450 (CYP) 3A subfamily in the metabolism of vincristine is well established. However, information is limited regarding vincristine's drug interaction profile. All the substrates and inhibitors of CYP3A4 such as the azole antifungals (itraconazole, ketoconazole), cyclosporine, isoniazid, and nifedipine have very high propensity to interfere with vincristine metabolism. The proposed mechanism is most likely attributed to either inhibition of 3A4 enzymes or blockade of P-glycoprotein pumps. These interactions are clinically significant and can lead to severe vincristine toxicity if not detected. Although case reports discussed here exclusively involve vincristine, it is important to assume that all vinca alkaloids interact in the same manner until proved otherwise, because they share similar metabolism pathways.

Fundamentals course for 1st-year radiology residents.

RATIONALE AND OBJECTIVES: The authors set out to provide 1st-year residents with basic knowledge to make conferences more useful, to make their knowledge more uniform, and to assess their competency to begin night call. MATERIALS AND METHODS: Faculty taught three afternoon sessions a week in subspecialty areas of radiology, including physics, during the 1st 6 months of residency. Material selected was believed to be essential for the understanding of that subspecialty's didactic lecture series. Emphasis was also placed on diagnoses residents would be expected to make once they began taking night call. Material was presented through lectures, images, and unknown cases. An examination was administered at the end of the course. Residents were allowed to begin night call only after completing the course and passing the final examination. RESULTS: All 1st-year residents completed the course and passed the examination. Their scores ranged from 70% to 83.3%. CONCLUSION: Residents liked the course and reported feeling ready to begin call. Faculty reported the residents who completed the course were more knowledgeable prior to formal rotations than residents from previous years who had not taken the course.