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https://www.readbyqxmd.com/read/29244141/telavancin-for-refractory-mrsa-bacteraemia-in-intermittent-haemodialysis-recipients
#1
Nicholas S Britt, Samad Tirmizi, David J Ritchie, Jeffrey E Topal, Dayna McManus, Victor Nizet, Ed Casabar, George Sakoulas
Background: Patients with end-stage renal disease (ESRD) requiring intermittent haemodialysis (IHD) are at high risk of MRSA bacteraemia (MRSA-B) and often fail first-line therapy. The safety, effectiveness and optimal dosing of telavancin for MRSA-B in this patient population are unclear. Objectives: We aimed to describe clinical outcomes of telavancin in the treatment of refractory MRSA-B in patients with ESRD requiring IHD. Patients and methods: This was a retrospective study of hospitalized patients at two tertiary care academic medical centres with recurrent or persistent (≥3 days) MRSA-B treated with telavancin monotherapy...
December 13, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29242417/phase-changing-material-for-therapeutic-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy-a-multi-centric-study
#2
Niranjan Thomas, Thangaraj Abiramalatha, Vishnu Bhat, Manoj Varanattu, Suman Rao, Sanjay Wazir, Leslie Lewis, Umamaheswari Balakrishnan, Srinivas Murki, Jaikrishnan Mittal, Ashish Dongara, Y N Prashantha, Somashekhar Nimbalkar
OBJECTIVE: To assess the feasibility and safety of cooling asphyxiated neonates using phase changing material based device across different neonatal intensive care units in India. DESIGN: Multi-centric uncontrolled clinical trial. SETTING: 11 level 3 neonatal units in India from November 2014 to December 2015. PARTICIPANTS: 103 newborn infants with perinatal asphyxia, satisfying pre-defined criteria for therapeutic hypothermia...
December 14, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29236303/impact-of-antimicrobial-stewardship-program-on-hospitalized-patients-at-the-intensive-care-unit-a-prospective-audit-and-feedback-study
#3
Maher R Khdour, Hussein O Hallak, Mamoon Al-Deyab, Mowafq A Nasif, Aliaa M Khalili, Ahamad A Dallashi, Mohammad B Khofash, Michael G Scott
AIMS: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. METHODS: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015...
December 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29233529/innovating-patient-care-delivery-dsrip-s-interrupted-time-series-analysis-paradigm
#4
Amrita G Shenoy, Charles E Begley, Lee Revere, Stephen H Linder, Stephen P Daiger
INTRODUCTION: Adoption of Medicaid Section 1115 waiver is one of the many ways of innovating healthcare delivery system. The Delivery System Reform Incentive Payment (DSRIP) pool, one of the two funding pools of the waiver has four categories viz. infrastructure development, program innovation and redesign, quality improvement reporting and lastly, bringing about population health improvement. BACKGROUND: A metric of the fourth category, preventable hospitalization (PH) rate was analyzed in the context of eight conditions for two time periods, pre-reporting years (2010-2012) and post-reporting years (2013-2015) for two hospital cohorts, DSRIP participating and non-participating hospitals...
December 7, 2017: Healthcare
https://www.readbyqxmd.com/read/29233284/development-and-evaluation-of-an-overseas-clinical-rotation-program-for-undergraduate-pharmacy-students-in-japan
#5
Hisakazu Ohtani, Rieko Mitsui, Takeshi Akiyoshi, Ayuko Imaoka, Yoshihiro Abe, Motoko Kanke, Tomonori Nakamura, Patrick Foster, Mayumi Mochizuki
BACKGROUND AND PURPOSE: Internationalization of pharmacists, as well as pharmacy students, in terms of both the knowledge to care for international patients and to have medical information literacy, is a current concern in Japan. EDUCATIONAL ACTIVITY AND SETTING: Keio University Faculty of Pharmacy has developed an elective course for pharmacy students, based on written agreements with the United States and Thailand that establish a student clinical rotation exchange program...
May 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233160/comparison-of-mortality-prediction-models-in-acute-respiratory-distress-syndrome-undergoing-extracorporeal-membrane-oxygenation-and-development-of-a-novel-prediction-score-the-prediction-of-survival-on-ecmo-therapy-score-preset-score
#6
Michael Hilder, Frank Herbstreit, Michael Adamzik, Martin Beiderlinden, Markus Bürschen, Jürgen Peters, Ulrich H Frey
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy in acute respiratory distress syndrome (ARDS) patients but is associated with complications and costs. Here, we validate various scores supposed to predict mortality and develop an optimized categorical model. METHODS: In a derivation cohort, 108 ARDS patients (2010-2015) on veno-venous ECMO were retrospectively analysed to assess four established risk scores (ECMOnet-Score, RESP-Score, PRESERVE-Score, Roch-Score) for mortality prediction (receiver operating characteristic analysis) and to identify by multivariable logistic regression analysis independent variables for mortality to yield the new PRESET-Score (PREdiction of Survival on ECMO Therapy-Score)...
December 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29232645/pre-optimization-of-spinal-surgery-patients-development-of-a-neurosurgical-enhanced-recovery-after-surgery-eras-protocol
#7
Zarina S Ali, Tracy S Ma, Ali K Ozturk, Neil R Malhotra, James M Schuster, Paul J Marcotte, M Sean Grady, William C Welch
OBJECTIVE: Despite surgical, technological, medical, and anesthetic improvements, patient outcomes following elective neurosurgical procedures can be associated with high morbidity. Enhanced recovery after surgery (ERAS) protocols are multimodal care pathways designed to optimize patient outcomes by addressing pre-, peri-, and post-operative factors. Despite significant data suggesting improved patient outcomes with the adoption of these pathways, development and implementation has been limited in the neurosurgical population...
December 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29232564/neonatal-mortality-and-morbidity-in-the-post-implementation-period-of-a-neonatal-teaching-program-in-provincial-hospitals-in-laos
#8
S Schmidt, S Bounnack, T Hoehn
OBJECTIVES: Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. STUDY DESIGN: This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. METHODS: A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care...
December 9, 2017: Public Health
https://www.readbyqxmd.com/read/29231287/using-secondments-in-tertiary-health-facilities-to-build-paediatric-expertise-in-allied-health-professionals-working-in-rural-new-south-wales
#9
Carmel Blayden, Sonia Hughes, Jennifer Nicol, Susan Sims, Isobel J Hubbard
OUTLINE OF PROBLEM: Allied health professionals working in rural settings have broad caseloads requiring advanced skills as general specialists. This can include children with specialised needs. DESIGN: Educational secondments were coordinated for allied health professionals to achieve self-nominated learning objectives. Learning objectives were assessed using pre and post evaluations to determine the effect of the educational secondment on knowledge and confidence specific to the nominated learning outcomes...
December 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/29231234/feasibility-acceptability-and-effectiveness-of-integrated-care-for-copd-patients-a-mixed-methods-evaluation-of-a-pilot-community-based-programme
#10
Tania Carron, Pierre-Olivier Bridevaux, Karin Lörvall, Rachel Parmentier, Jean-Bernard Moix, Vincent Beytrison, Raymond Pernet, Constance Rey, Pierre-Yves Roberfroid, Prashant N Chhajed, Thomas Dieterle, Ladina Joos Zellweger, Malcolm Kohler, Sabrina Maier, David Miedinger, Robert Thurnheer, Pascal Urwyler, Jean-Marie Tschopp, Emilie Zuercher, Jörg Daniel Leuppi, Bernard Burnand, Isabelle Peytremann-Bridevaux
QUESTION UNDER STUDY: The aim of this study was to assess the feasibility, acceptability and effectiveness of a pilot COPD integrated care programme implemented in Valais, Switzerland. METHODS: The programme was adapted from the self-management programme Living Well with COPD, and included the following elements: self-management patient-education group sessions, telephone and medical follow-ups, multidisciplinary teams, training of healthcare professionals, and evidence-based COPD care...
December 12, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29229143/myocardial-functional-changes-in-transfemoral-versus-transapical-aortic-valve-replacement
#11
Niraj Asthana, Aditya Mantha, Eric H Yang, William Suh, Olcay Aksoy, Richard J Shemin, Gabriel Vorobiof, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has greatly expanded the treatment options available for patients with severe aortic stenosis at high surgical risk. MATERIALS AND METHODS: We compared changes in myocardial function in TAVR with a transfemoral (TF) versus a transapical (TA) approach at a major tertiary hospital from 2012-2016. Traditional echocardiographic measures of cardiac structure and function were tracked, alongside the use of two-dimensional speckle tracking echocardiography to measure myocardial strain and strain rates...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29228010/nasal-carriage-of-methicillin-resistant-staphylococcus-aureus-mrsa-at-a-palliative-care-unit-a-prospective-single-service-analysis
#12
Maria Heckel, Walter Geißdörfer, Franziska A Herbst, Stephanie Stiel, Christoph Ostgathe, Christian Bogdan
BACKGROUND: The emergence of multidrug-resistant bacterial microorganisms is a particular challenge for the health care systems. Little is known about the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacteria (MDRGNB) in patients of palliative care units (PCU). AIM: The primary aim of this study was to determine the carriage of MRSA among patients of a PCU at a German University Hospital and to assess whether the positive cases would have been detected by a risk-factor-based screening-approach...
2017: PloS One
https://www.readbyqxmd.com/read/29226815/integrative-assessment-of-congestion-in%C3%A2-heart-failure-throughout-the-patient%C3%A2-journey
#13
REVIEW
Nicolas Girerd, Marie-France Seronde, Stefano Coiro, Tahar Chouihed, Pascal Bilbault, François Braun, David Kenizou, Bruno Maillier, Pierre Nazeyrollas, Gérard Roul, Ludivine Fillieux, William T Abraham, James Januzzi, Laurent Sebbag, Faiez Zannad, Alexandre Mebazaa, Patrick Rossignol
Congestion is one of the main predictors of poor patient outcome in patients with heart failure. However, congestion is difficult to assess, especially when symptoms are mild. Although numerous clinical scores, imaging tools, and biological tests are available to assist physicians in ascertaining and quantifying congestion, not all are appropriate for use in all stages of patient management. In recent years, multidisciplinary management in the community has become increasingly important to prevent heart failure hospitalizations...
November 27, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#14
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
October 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29224789/pediatric-surgical-capacity-building-a-pathway-to-improving-access-to-pediatric-surgical-care-in-haiti
#15
Neema Kaseje, Hillary Jenny, Andre Patrick Jeudy, Jean Louis MacLee, John G Meara, Henri R Ford
PURPOSE: Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. MATERIALS/METHODS: A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29224600/evaluation-of-an-integrated-housing-and-recovery-model-for-people-with-severe-and-persistent-mental-illnesses-the-doorway-program
#16
David R Dunt, Andrew W Benoy, Andrea Phillipou, Laura L Collister, Elizabeth M Crowther, Julian Freidin, David J Castle
Objective The Doorway program is a 3-year pilot integrated housing and recovery support program aimed at people with a severe and persistent mental illness who are 'at risk' or actually homeless. Participants source and choose properties through the open rental market, with appropriate rental subsidy and brokerage support. This arrangement is highly innovative, differing from widely favoured arrangements internationally involving congregate and scattered-site housing owned or managed by the support program...
October 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29223430/rational-and-design-of-a-randomized-double-blind-multicenter-trial-to-evaluate-the-safety-and-tolerability-of-furosemide-withdrawal-in-stable-chronic-outpatients-with-heart-failure-the-rebic-1-trial
#17
Priscila Raupp da Rosa, Luis E Rohde, Madeni Doebber, Antonio L P Ribeiro, Deborah P Prado, Eduardo G Bertoldi, Jose A Figueiredo Neto, Ilmar Kohler, Luis Beck-da-Silva, Luiz C Danzmann, Lidia Zytynski Moura, Marciane Rover, Marcus V Simões, Roberto T Sant'Anna, Andréia Biolo
AIMS: Furosemide is commonly prescribed for symptom relief in heart failure (HF) patients. Although few data support the continuous use of loop diuretics in apparently euvolemic HF patients with mild symptoms, there is concern about safety of diuretic withdrawal in these patients. The ReBIC-1 trial was designed to evaluate the safety and tolerability of withdrawing furosemide in stable, euvolemic, chronic HF outpatients. This multicenter initiative is part of the Brazilian Research Network in Heart Failure (ReBIC) created to develop clinical studies in HF and composed predominantly by university tertiary care hospitals...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29219878/community-based-management-of-multiple-drug-resistant-tuberculosis-in-a-tertiary-hospital-in-tanzania-a-best-practice-implementation-project
#18
Isaya Jelly, Micah D J Peters
BACKGROUND: The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. AIM: The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219242/behavioural-assessment-unit-improves-outcomes-for-patients-with-complex-psychosocial-needs
#19
George Braitberg, Marie Gerdtz, Susan Harding, Steven Pincus, Michelle Thompson, Jonathan Knott
OBJECTIVE: We aimed to assess the impact of a new model of care for patients presenting to the ED with acute behavioural disturbance. METHODS: This pre-/post-intervention study involved creating a dedicated, highly resourced six bed unit, the behavioural assessment unit (BAU). Co-located with the ED at the Royal Melbourne Hospital, the unit was designed to fast-track the admission of patients affected by intoxication, mental illness or psychosocial crisis and provide front-loaded interventions...
December 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#20
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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