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BACKGROUND KPC-type carbapenemases are increasingly prevalent in parts of the USA and Israel and are an emerging concern in South America, Europe and China. We investigated the UK's first two KPC-producing Klebsiella pneumoniae isolates. METHODS The isolates were referred to the UK's national reference laboratory for confirmation of carbapenem resistance.… (More)
OBJECTIVE The aim of the study was to evaluate the use of proviral DNA as a source of viral genetic material for genotypic coreceptor tropism testing (GTT). METHODS GTT consisted of bulk V3 sequencing followed by geno2pheno interpretation with the interpretative cut-off [false positive rate (FPR)] set at 5 and 10%. GTT was performed for 165 patients with… (More)
BACKGROUND Temocillin, a β-lactam stable against most β-lactamases [including extended-spectrum β-lactamases (ESBLs) and derepressed AmpC cephalosporinases (dAmpC)], has been suggested as an alternative to carbapenems when Pseudomonas can be excluded. Aims To assess temocillin clinical and microbiological cure rates (CCR and MCR) in infection caused by… (More)
In current American medical practice, autonomy is assumed to be more valuable than human life: if a patient autonomously refuses lifesaving treatment, the doctors are supposed to let him die. In this paper we discuss two values that might be at stake in such clinical contexts. Usually, we hear only of autonomy and best interests. However, here, autonomy is… (More)
According to bioethics orthodoxy, when we ask, "What would the patient choose?" the patient's autonomy is at stake. In fact, what underpins the moral force of that question is a value different from either autonomy or best interests. This is the value of doing things in a way that is authentic to the person.
BACKGROUND Maraviroc (MVC) has shown good efficacy and tolerability in treatment-naive and treatment-experienced HIV-1-infected patients with CCR5-tropic virus. Data on patients switching to MVC while on suppressive antiretroviral therapy (ART) are limited. The aim of this study was to evaluate patients on suppressive ART switching to an MVC-containing… (More)
When does behavior trigger a lesser claim to medical resources? When does chronic drinking, for example, mean that one has a lesser claim to a liver transplant? Only when one's behavior becomes a callous indifference to others' needs--when one knows the consequences of heavy drinking and knows that by drinking one may end up depriving someone else of a… (More)
I magine a patient, Bill, who has lost decision-making capacity. An important treatment decision must be made, but Bill cannot make it. Assume there is no advance directive or anything equivalent. There is no way to take a statement made by Bill, when competent, and apply it to the current setting. A standard move in cases like this is to have the patient's… (More)