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https://www.readbyqxmd.com/read/28426451/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#1
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28353459/first-report-of-kocuria-marina-bloodstream-infection-unrelated-to-a-central-venous-catheter-a-mini-review-on-an-emerging-and-under-recognized-opportunistic-pathogen
#2
Giovanna Pulcrano, Michela Balzaretti, Alessia Grosini, Vincenzo Piacentini, Dimitri Poddighe
We report a case of sepsis by Kocuria marina in a 45-year-old woman carrying a midline venous catheter to provide total parenteral nutrition. Despite the finding of K. marina bacteraemia, no bacteria grew from the culture of the catheter tip. As the patient was affected with severe leg ulcers, K. marina bloodstream infection from a skin breakage other than CVC was supposed. K. marina is an emerging opportunistic agent deserving attention and probably under-recognized, as it can be misdiagnosed as Staphylococcus if only conventional microbiological analyses are performed for bacterial identification...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#3
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#4
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28328622/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#5
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
March 21, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28152722/integrating-lean-six-sigma-in-the-daily-operations-of-an-icu-to-achieve-safe-quality-patient-care
#6
Jacqueline Magurn, Joanne McGovern, Michelle Jetter, Sarah Beadling, Dorothy Gregoire
230 Background: Developing and maintaining a culture of safety and quality in delivering patient care is critical in the intensive care unit (ICU) especially an oncology ICU. Incorporating the Lean Six Sigma program into daily operations of the ICU achieves, simplifies, and sustains continuous improvement in the delivery of safe quality patient care. This program engages the ICU team through visual management of quality, safety, and budget indicators including medication scanning, falls, sharps exposure, infection prevention including blood stream, catheter, hospital and ventilator acquired pneumonias, venous embolism prevention, and staffing compliance...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28104503/invasive-candida-krusei-infection-and-candida-vasculitis-of-a-leg-ulcer-in-an-immunocompetent-patient-a-case-report
#7
Philipp Jud, Thomas Valentin, Sigrid Regauer, Thomas Gary, Gerald Hackl, Peter Rief, Marianne Brodmann, Franz Hafner
A 71year old female Caucasian farmer without any known immunosuppression presented with a painful ulcer of her right lower leg after a trauma caused by a wood billet. There was no response to empirical antibacterial treatment. An ulcer biopsy showed an invasive Candida infection of the soft tissue and leucocytoclastic vasculitis. Voriconazole treatment was followed by wound healing. Invasive Candida infection and localized Candida vasculitis represent a rare cause of persisting leg ulcers. The similar clinical picture of chronic venous leg ulcers might blur the true cause and refractory cases should therefore promptly be processed by histopathological diagnostics...
February 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#8
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28088662/metabolic-profiles-of-exudates-from-chronic-leg-ulcerations
#9
Adam Junka, Wojciech Wojtowicz, Adam Ząbek, Grzegorz Krasowski, Danuta Smutnicka, Barbara Bakalorz, Agnieszka Boruta, Mariusz Dziadas, Piotr Młynarz, Parish Paymon Sedghizadeh, Marzenna Bartoszewicz
Chronic leg ulceration is a disease usually associated with other comorbidities, and significantly reduces patient quality of life. Infected leg ulcers can lead to limb-threatening sequelae or mortality. Leg ulcerations are colonized by a number of microbes that are able to cause life-threating infections in susceptible patients. Wound exudate is a body fluid that collects metabolites from patient eukaryotic cells and from prokaryotic bacterial communities inhabiting the wound. This study aimed at identification of metabolites in exudates collected from chronic leg ulcers, and correlation of this metabolome with patient comorbidities and microbiological status of the wound...
January 10, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#10
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/27974009/therapeutic-effectiveness-of-a-calendula-officinalis-extract-in-venous-leg-ulcer-healing
#11
M Buzzi, F de Freitas, M de Barros Winter
OBJECTIVE: Non-healing venous leg ulcers (VLUs) have a significant effect on patients' quality of life and substantially increase expenditures in health-care systems. The aim of this study was to evaluate the clinical efficacy of the Calendula officinalis extract, Plenusdermax, in the treatment of VLUs. METHOD: Patients treated with Calendula officinalis extract (n=38) and control patients (n=19) were evaluated every two weeks for 30 weeks or until their ulcers healed...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27933134/pitfalls-in-histoacryl-glue-injection-therapy-for-oesophageal-gastric-and-ectopic-varices-a-review
#12
REVIEW
Lulia Al-Hillawi, Terence Wong, Giovanni Tritto, Philip A Berry
Histoacryl glue is used increasingly for the treatment of gastric and ectopic varices, and there is experience in its use for oesophageal varices. It is an effective treatment, yet numerous reports of complications have accumulated. This review of the literature describes the technique, explores circulatory and vascular consideration unique to portal hypertension and categorises the complications into: "Embolisation", "local venous thrombosis", "fistulisation and extravascular injection", "ulceration, erosion and extrusion", and "nidus of infection"...
November 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#13
REVIEW
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27871229/-the-cango-lyec-project-healing-the-elephant-hiv-related-vulnerabilities-of-post-conflict-affected-populations-aged-13-49-years-living-in-three-mid-northern-uganda-districts
#14
Samuel S Malamba, Herbert Muyinda, Patricia M Spittal, John P Ekwaru, Noah Kiwanuka, Martin D Ogwang, Patrick Odong, Paul K Kitandwe, Achilles Katamba, Kate Jongbloed, Nelson K Sewankambo, Eugene Kinyanda, Alden Blair, Martin T Schechter
BACKGROUND: The protracted war between the Government of Uganda and the Lord's Resistance Army in Northern Uganda (1996-2006) resulted in widespread atrocities, destruction of health infrastructure and services, weakening the social and economic fabric of the affected populations, internal displacement and death. Despite grave concerns that increased spread of HIV/AIDS may be devastating to post conflict Northern Uganda, empirical epidemiological data describing the legacy of the war on HIV infection are scarce...
November 21, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27792719/-comparative-study-of-the-efficacy-of-larva-therapy-for-debridement-and-control-of-bacterial-burden-compared-to-surgical-debridement-and-topical-application-of-an-antimicrobial
#15
José Contreras-Ruiz, Adán Fuentes-Suárez, Sara Arroyo-Escalante, David Moncada-Barron, María Cristina Sosa-de-Martínez, Ernesto Maravilla-Franco, Judith Guadalupe Domínguez-Cherit
Maggot debridement therapy (MDT) is the use of medical grade maggots of the fly Lucilia sericata for wound debridement. Recent observations show that MDT decreases bacterial burden as well. Venous ulcers are the most commonly seen in wound clinics and require, besides adequate treatment of venous hypertension, proper wound bed preparation with debri dement of necrotic tissue and control of potential infections. To evaluate the efficacy of MDT in venous ulcers a randomized controlled trial was designed to compare MDT to surgical debridement and topical application of silver sulfadiazine (SSD) in 19 patients for 4 weeks...
October 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27785377/peroxy-pyruvic-acid-containing-topical-anti-infective-a-potential-candidate-for-a-wound-instillation-solution
#16
Edwin D Neas, Julie A Dunn, Evelyn Dimaano Silva, A Morgan Chambers, Gary J Luckasen, Adam Jaskowiak
Objective: Evaluate the therapeutic properties of a peroxy pyruvic acid (PPA)-containing topical anti-infective in a human ex-vivo model that replicates the natural conditions of a human chronic wound. Approach: Wound material was extracted from patients with nonhealing diabetic ulcers, venous stasis ulcers, and arterial wounds. Microbial species were identified, and wound colonization was quantified. Extracted samples were then exposed to a PPA-containing topical anti-infective as an instillation solution with negative pressure wound therapy NPWT at concentrations of 1,000, 1,500, or 2,500 ppm for a period of 1, 5, or 10 min to determine the effect of exposure on isolated pathogens, including effect on proteins...
October 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27742997/bacterial-contribution-in-chronicity-of-wounds
#17
REVIEW
Kashif Rahim, Shamim Saleha, Xudong Zhu, Liang Huo, Abdul Basit, Octavio Luiz Franco
A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers...
April 2017: Microbial Ecology
https://www.readbyqxmd.com/read/27703067/fibrin-gel-versus-papain-gel-in-the-healing-of-chronic-venous-ulcers-a-double-blind-randomized-controlled-trial
#18
Illymack Cf de Araújo, Elenice Defune, Luciana Pf Abbade, Hélio A Miot, Matheus Bertanha, Lídia R de Carvalho, Rosana R Ferreira, Winston B Yoshida
OBJECTIVES: Compare the efficacy and safety of fibrin gel to 8% papain gel for wound dressing of venous ulcers. METHOD: Patients with chronic venous ulcers were randomly assigned to one in three groups: Group 1-fibrin gel; Group 2-8% papain gel; Group 3-carbopol gel (control). Patients were seen every 15 days during 2 months, verifying reduction of the ulcer area, local infection, exudation, and epithelization. All serious or nonserious adverse events were recorded...
October 4, 2016: Phlebology
https://www.readbyqxmd.com/read/27695634/phenol-rich-compounds-sweet-gel-a-statistically-more-effective-antibiotic-than-cloxacillin-against-pseudomonas-aeruginosa
#19
Mehrab Dashtdar, Mohammad Reza Dashtdar, Babak Dashtdar, Gazala Afreen Khan, Karima Kardi
OBJECTIVES: The purpose of this study was to obtain a natural antibiotic from Phenol-rich compounds; for the dressing and the treatment of chronic wounds. METHODS: The Phenol-rich compound sweet gel was prepared by blending four natural herbal extracts, Acacia catechu (L.F.), Momia (Shilajit), Castanea sativa, and Ephedra sinica stapf, with combination of a sweet gel medium, including honey, maple saps, Phoenix dactylifera L. (date), pomegranate extract and Azadirachta indica gum as a stabilizer...
September 2016: Journal of Pharmacopuncture
https://www.readbyqxmd.com/read/27663530/ll-37-but-not-25-hydroxy-vitamin-d-serum-level-correlates-with-healing-of-venous-leg-ulcers
#20
Alicja Krejner, Małgorzata Litwiniuk, Tomasz Grzela
Human cathelicidin, LL-37, is small antimicrobial peptide, which reveals also some immunomodulatory and proangiogenic properties and, therefore, may promote wound healing. The expression of LL-37 is controlled by various factors, including vitamin D. Thus, any disturbances in vitamin D level may influence LL-37 production and, possibly, affect wound healing. Since deficiency of vitamin D was identified as a common problem in the population, this proof of concept study aimed to verify the relationship between serum levels of LL-37, vitamin D, and healing rate of venous leg ulcers...
September 23, 2016: Archivum Immunologiae et Therapiae Experimentalis
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