Swain Demir (knifesuede06)

Background There have been declining mortality rates associated with pyogenic liver abscess (PLA) in recent decades due to improvements in percutaneous drainage techniques, access to imaging and improvements in supportive care. The aim of this study was to analyse the aetiology, management and outcome of PLA at a tertiary hospital in Adelaide. Methods Data was collected retrospectively from 80 patients who were admitted with a PLA between 2011 and 2018. The data points covered demographic variables, presumed aetiology, microbiology results, abscess imaging characteristics, interventions, antibiotic treatment, complications and mortality. Results The majority of patients were Caucasian (86%) and the most common predisposing conditions were biliary tract disease (39%), intra-abdominal infection (20%) and diabetes (18%). Escherichia coli (21%), Klebsiella species (18%), Streptococcus anginosus group (14%) and anaerobes (18%) were the most frequent pathogens isolated. Fifty-one percent of patients were bacteraemic. Percutaneous catheter insertion (45%) was the most common form of drainage followed by percutaneous aspiration (13%), surgery (11%) and endoscopic retrograde cholangiopancreatography (6%), while 25% of patients did not undergo any form of drainage. Twenty-four patients (30%) suffered a complication with the highest proportion occurring in the medically managed group. The overall mortality rate was 9% with only 1% mortality rate attributable to PLA. Conclusion This study demonstrates a continued preference for percutaneous drainage techniques over surgery in the management of PLA. A significant proportion of patients did not undergo abscess drainage and the risk of subsequent complications appeared to concentrate in this group, although the mortality rate from PLA was low.Historical comparisons of body size often lack pertinent details, including information on the sampling protocol and relevant ecological covariates that influence body size. Moreover, historical estimates of body size that rely on museum specimens may be biased towards larger size classes because of collector preferences, and thus size thresholds have been used to focus attention on maximum body size. We tested the consequences of sampling design, ecological covariates, and size thresholds on inferences of body-size change using field-contextualized historical records, rather than museum specimens. In 2014-2015, we revisited historical (1947-1963) size-frequency distributions of three gastropods (Tegula funebralis, Lottia digitalis/L. austrodigitalis, Littorina keenae) in the context of population density and tidal height. In general, gastropods declined in size. However, our inferences regarding body-size decline were tempered when the variation between sampling units was taken into consideration, resulting in greater uncertainty around the estimate of proportional change in body size. Gastropod size was correlated with population density and tidal height, and these relationships varied over time. Finally, the magnitude and direction of body-size change varied with the amount of data available for analysis, demonstrating that the use of size thresholds can lead to incomplete conclusions.Objectives To assess if a standard hydration protocol will achieve voided volumes over 150 mL and more reliable uroflowmetry results. Methods This is a single-blinded crossover study of 40 patients with benign prostatic obstruction and 34 healthy volunteers. Subjects were enrolled prospectively between January and March 2019. All subjects performed two randomly ordered uroflowmetry tests. One test was performed when subjects sensed their bladder was full and had the urge to void and another one after emptying the bladder and ingesting 1.5 L of water within 1 hour (prehydration). Uroflowmetry parameters were compared between the benign prostatic obstruction group and the healthy volunteers. Uroflowmetry results were categorized as reliable, residual, and suboptimal wit