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- van Buul, Laura W, et al.
(author)
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The Development of a Decision Tool for the Empiric Treatment of Suspected Urinary Tract Infection in Frail Older Adults: A Delphi Consensus Procedure.
- 2018
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In: Journal of the American Medical Directors Association. - : Elsevier BV. - 1538-9375 .- 1525-8610. ; 19:9, s. 757-764
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Journal article (peer-reviewed)abstract
- Nonspecific signs and symptoms combined with positive urinalysis results frequently trigger antibiotic therapy in frail older adults. However, there is limited evidence about which signs and symptoms indicate urinary tract infection (UTI) in this population. We aimed to find consensus among an international expert panel on which signs and symptoms, commonly attributed to UTI, should and should not lead to antibiotic prescribing in frail older adults, and to integrate these findings into a decision tool for the empiric treatment of suspected UTI in this population.A Delphi consensus procedure.An international panel of practitioners recognized as experts in the field of UTI in frail older patients.In 4 questionnaire rounds, the panel (1) evaluated the likelihood that individual signs and symptoms are caused by UTI, (2) indicated whether they would prescribe antibiotics empirically for combinations of signs and symptoms, and (3) provided feedback on a draft decision tool.Experts agreed that the majority of nonspecific signs and symptoms should be evaluated for other causes instead of being attributed to UTI and that urinalysis should not influence treatment decisions unless both nitrite and leukocyte esterase are negative. These and other findings were incorporated into a decision tool for the empiric treatment for suspected UTI in frail older adults with and without an indwelling urinary catheter.A decision tool for suspected UTI in frail older adults was developed based on consensus among an international expert panel. Studies are needed to evaluate whether this decision tool is effective in reaching its aim: the improvement of diagnostic evaluation and treatment for suspected UTI in frail older adults.
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| 5. |
- Eriksson, Mattias, et al.
(author)
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Fe II fluorescence in symbiotic stars
- 2004
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In: Revista Mexicana de Astronomia y Astrofisica Conference Series 21. - Merida, Yucatan, Mexico. ; , s. 132-136
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Conference paper (peer-reviewed)
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| 6. |
- Eriksson, M, et al.
(author)
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Modeling of C IV pumped fluorescence of Fe II in symbiotic stars
- 2008
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In: Astronomy & Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 477:1, s. 255-265
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Journal article (peer-reviewed)abstract
- Aims. We describe how the C IV lambda 1548.18 line pumps the 1548.20 and 1548.41 angstrom channels of Fe II in symbiotic stars through the process known as photo-ionization by accidental resonance (PAR). We describe where and why Fe II fluorescence arises in symbiotic stars and whether the Fe II lambda 1548.41 channel can only be activated when there is a white-dwarf wind present in the system. Further, we aim to show how an analysis of the PAR-pumped lines helps to understand the phyisical conditions that they manifest. Methods. We calculate intensities of the C IV-pumped Fe II fluorescence lines in symbiotic stars, corresponding to the y(4)H(11/)2 and w(2)D(3/2) levels, based on a simple geometrical model of the emitting regions. We apply the model to seven symbiotic stars, known to have Fe II fluorescence lines pumped by C IV in their spectra. We compare the predicted intensities to the observed intensities of the selected symbiotic stars. Results. We find that we can reproduce the observed fluorescence intensities of the seven symbiotic stars in our sample, using parameters that are consistent with their known properties. We show that PAR-produced lines can be used as a diagnostic tool to derive important physical parameters of a stellar system. We suggest that the detection of Fe II lines corresponding to the w2D3/2 level in certain symbiotic stars provide evidence of hot shells expanding with velocities of at least hundreds km s(-1) in those systems.
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