Influence of adjuvant antibiotics on fistula formation following incision and drainage of anorectal abscesses: a systematic review protocol

The objective of this review is to summarize the available evidence on the role of antibiotics following I&D of anorectal abscesses on fistula formation. Secondary objectives include determining if antibiotics are associated with morbidity, repeat presentation to the emergency department, and requirement for reoperation.Methods/designMEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials,http://apps.who.int/trialsearch, andclinicaltrials.gov will be searched to identify published and ongoing unpublished interventional and observational studies evaluating the role of antibiotics post I&D on the incidence of fistula formation. There will be no restriction on language, date, or journal. Title and abstracts as well as full texts will be screened in duplicate based on inclusion and exclusion criteria. The Cochrane Risk of Bias tool and ROBINS-I will be used to assess risk of bias in randomized and non-randomized studies, respectively. Our primary outcome is the incidence of fistula formation; secondary outcomes include morbidity, representation to ED, and reoperation. Study heterogeneity will be calculated with Cochran ’sQ test,P value, andI2 index. SASS (version 9.4) will be used for meta-analysis.DiscussionThis is the first study to review the available evidence on adjuvant antibiotics and incidence of fistula formation following I&D of anorectal abscesses.Systematic review registrationPROSPEROCRD42018092044
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research

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Conclusion: Results suggest that T20 has a double-target mechanism, by which its N-terminal and C-terminal portions bind to N-terminal heptad repeat and FPPR, respectively. T20-SF designed based on this new mechanism exhibits significantly improved anti-HIV-1 activity because it targets the triple sites in gp41, including N-terminal heptad repeat, FPPR, and fusion peptide. Thus, this study provides clues for designing novel HIV fusion inhibitors with improved antiviral activity.
Source: AIDS - Category: Infectious Diseases Tags: BASIC SCIENCE Source Type: research
Conclusion: These results indicate that Tg26+/−/ApoE−/− serve as a new mouse model for HIV-induced atherogenesis, and aid in understanding the role of tryptophan catabolism in the pathogenesis of HIV atherosclerosis/CVD.
Source: AIDS - Category: Infectious Diseases Tags: BASIC SCIENCE Source Type: research
Conclusion: Our data explore the hypothesis that poorly recognized epitope variants not only facilitate HIV-1 evasion of CTL recognition, but also induce CTL dysfunction through suboptimal signaling causing anergy. However, the results do not suggest that suboptimal signaling induces anergy (or exhaustion or apoptosis), indicating that the major role of CTL epitope variation is likely viral escape.
Source: AIDS - Category: Infectious Diseases Tags: BASIC SCIENCE Source Type: research
Background: Many of those aging with HIV suffer from distal neuropathic pain (DNP) due to HIV-associated sensory neuropathy (HIV-SN). Prior studies have linked chronic pain conditions to a variant of the catechol-O-methyltransferase (COMT), Val158Met. This variant confers reduced enzymatic activity and results in higher synaptic dopamine levels. Here we examined the role of Val158Met as a predictor of DNP in HIV-SN. Methods: In 1044 HIV-infected individuals enrolled in CNS HIV Antiretroviral Therapy Effects Research, an observational study across six US institutions, we characterized the relationship between Val158Met...
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research
Conclusion: Switching to E/C/F/TAF was noninferior to continuing ABC/3TC plus a third agent for maintenance of HIV RNA suppression at Week 24. This study supports E/C/F/TAF as an efficacious and well tolerated option for participants switching from ABC/3TC-based regimens.
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research
Conclusion: ART-naive Ethiopian HIV patients had a high prevalence of prediabetes and diabetes, with a poor agreement between HbA1c and OGTT. Diabetes was associated with inflammation, but not with adiposity and age. Diabetes was linked to insulin deficiency, rather than insulin resistance, which may represent a different entity than type 1 and 2 diabetes. This has implications for choice of drugs, when managing diabetes in African HIV patients.
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research
Conclusion: Neuropsychiatric illness increased odds of being frail on a predominantly physical/motoric measure, but only when symptomatic. Lack of association with asymptomatic impairment may reflect the importance of functional limitation to frailty, or possibly a unique resilience phenotype. Understanding why sex and symptomatic neuropsychiatric illness are associated with frailty will be important in managing HIV-associated morbidity in aging populations.
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research
Conclusion: E157Q substitution, reducing raltegravir and elvitegravir activity, was frequently found in acute/recent HIV cases. All cases were infected with subtype B, and some were included in clusters. Cases treated with dolutegravir-based regimens had good virological response.
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE: CONCISE COMMUNICATIONS Source Type: research
Conclusion: Among women at risk of HIV-1 infections in South Africa, we found no statistically significant differences in HIV-1 incidence by contraceptive method. Implants had the lowest point estimate for HIV-1 incidence, and IUDs had risk comparable with injectable methods in multivariate models. Large, prospective studies are needed to define better the relative HIV-1 risks across different contraceptive methods.
Source: AIDS - Category: Infectious Diseases Tags: CLINICAL SCIENCE: CONCISE COMMUNICATIONS Source Type: research
Conclusion: Despite high ART coverage, good maternal health and very low vertical HIV transmission rate, maternal HIV infection remained associated with increased risk of adverse perinatal outcomes. Larger studies using first trimester ultrasound for pregnancy dating are needed to further assess associations with specific adverse perinatal outcomes.
Source: AIDS - Category: Infectious Diseases Tags: EPIDEMIOLOGY AND SOCIAL Source Type: research
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