Telemedicine
A pilot study published in the December 7, 2004, issue of the Journal of Telemedicine and Telecare suggests that leg wounds can be successfully monitored remotely. The study included 34 home health patients with a leg wound as their primary diagnosis. Visiting nurses took digital photographs of the wounds, and then sent the images and patient information to an enterostomal therapy nurse (ETN). Using Medicare's Outcome and Assessment Information Set (OASIS), investigators found that the home health nurse and the ETN generally agreed in their wound assessments. This indicated that the digital images accurately represented the wounds.
Opinions about treatment options often differed between the home health nurse and the ETN, however, suggesting that access to specialty wound care could ultimately improve clinical outcomes. With a shortage of ETNs and demands of an aging population, the remote monitoring study demonstrated the ability to give more patients quick access to the expertise of wound care specialists, noted Joseph Kvedar, MD, director of Partners Telemedicine and President of the American Telemedicine Association.
Information:http://www.telemedicine.partners.org
Surgical Site Infections
Surgical site infections (SSIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) were more likely to resolve when treated with the antibiotic ZYVOX (linezolid; Pfizer Inc, New York, NY) than when treated with vancomycin. Data from a study comparing the 2 drugs for this indication were published in the December 2004 issue of the American Journal of Surgery. Study analysis also showed that the mean duration of treatment was significantly shorter (6 days) for patients who received ZYVOX than for those treated with vancomycin. About 500,000 postoperative SSIs occur each year.
The randomized, open-label, comparator-controlled, multicenter, multinational study of 1200 patients was designed to compare the clinical efficacy, safety, and tolerability of ZYVOX versus vancomycin for complicated skin and soft tissue infections. The intent-to-treat population consisted of 66 patients who received ZYVOX and 65 patients who received vancomycin. In these 2 groups, 65 patients had SSIs caused by MRSA. Patients were randomized to receive intravenous or oral ZYVOX, 600 mg every 12 hours, or intravenous vancomycin, 1 g every 12 hours, for 7 to 21 days. The primary efficacy outcome was clinical response to treatment 7 days after completing therapy.
In the post hoc analysis, patients in the MRSA subgroup treated with ZYVOX had microbiologic success rates of 87%, compared with 48% for patients on vancomycin. The most common adverse effects reported for both drugs were gastrointestinal and hematological in nature, including nausea, vomiting, constipation, and anemia.
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