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https://www.readbyqxmd.com/read/28448786/microbiological-features-and-clinical-impact-of-the-type-vi-secretion-system-t6ss-in-acinetobacter-baumannii-isolates-causing-bacteremia
#1
Jungok Kim, Ji-Young Lee, Haejeong Lee, Ji Young Choi, Dae Hun Kim, Yu Mi Wi, Kyong Ran Peck, Kwan Soo Ko
We investigated the genetic background and microbiological features of T6SS-positive Acinetobacter baumannii isolates and clinical impact of the T6SS in patients with A. baumannii bacteremia. One hundred and sixty-two A. baumannii isolates from patients with bacteremia in two tertiary-care hospitals in Korea were included in this study. Approximately one-third (51/162, 31.5%) of the A. baumannii clinical isolates possessed the hcp gene, and the hcp-positive isolates were found in several genotypes in multilocus sequence typing...
April 27, 2017: Virulence
https://www.readbyqxmd.com/read/28445893/early-mortality-associated-with-inpatient-versus-outpatient-hemodialysis-initiation-in-a-large-cohort-of-us-veterans-with-incident-end-stage-renal-disease
#2
Faisal M Arif, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Jun Ling Lu, Fatima Hassan, Fridtjof Thomas, Omer A Siddiqui, Geeta G Gyamlani, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Mortality in the immediate post-hemodialysis transition period is extremely high. Many end-stage renal disease (ESRD) patients in the US start dialysis in an inpatient setting, but the characteristics of patients starting dialysis as inpatients, and the association of inpatient hemodialysis transition with mortality remain unclear. METHODS: We examined 48,261 US veterans who transitioned to hemodialysis between October 2007 and September 2011. Associations of inpatient hemodialysis starting with all-cause mortality were examined in Cox proportional hazard models, with adjustments for demographics, comorbidities, vascular access type, pre-dialysis nephrology care and medication use, and last pre-ESRD estimated glomerular filtration rate and hemoglobin...
April 27, 2017: Nephron
https://www.readbyqxmd.com/read/28444360/role-of-early-onset-neutropenia-in-development-of-candidemia-in-premature-infants
#3
Nermin Ramy, Mohamed Hashim, Heba Abou Hussein, Happy Sawires, Maha Gaafar, Ayat El Maghraby
Background: The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. Materials and Methods: This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others...
April 24, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28443388/utilization-of-thoracic-ultrasound-for-confirmation-of-central-venous-catheter-placement-and-exclusion-of-pneumothorax-a-novel-technique-in-real-time-application
#4
Dileep Raman, Manish Sharma, Ajit Moghekar, Xiaofeng Wang, Umur Hatipoğlu
AIM: To evaluate the safety and utility of ultrasonography as a tool to confirm central venous catheter (CVC) position and to exclude insertion-related pneumothorax in place of chest radiography (CXR) in a tertiary medical intensive care unit (ICU). METHODS: We randomized 60 consecutive medical ICU patients to conventional or ultrasound groups for CVC placement. Both groups had CVCs inserted under ultrasound guidance. The intervention group underwent real-time transthoracic echocardiography to assist in catheter positioning and chest ultrasonography for exclusion of pneumothorax...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#5
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#6
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28442933/drainage-of-malignant-ascites-patient-selection-and-perspectives
#7
REVIEW
Maciej Stukan
Malignant ascites (MA) is a sign of advanced cancer and poor prognosis. MA can result in impairment in quality of life (QOL) and significant symptoms. As a supportive treatment, ascites can be drained by paracentesis (PC), percutaneously implanted catheters (tunneled, untunneled, central venous catheters), or peritoneal ports, or peritoneovenous shunts. The aim of this study was to evaluate the effectiveness, safety, and patient-reported outcomes (PRO) of different drainage methods for the management of MA...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28442306/evaluation-of-a-real-time-pcr-assay-for-rectal-screening-of-oxa-48-producing-enterobacteriaceae-in-a-general-intensive-care-unit-of-an-endemic-hospital
#8
J Fernández, S A Cunningham, A Fernández-Verdugo, L Viña-Soria, L Martín, M R Rodicio, D Escudero, F Vazquez, J N Mandrekar, R Patel
Carbapenemase-producing Enterobacteriaceae are increasing worldwide. Rectal screening for these bacteria can inform the management of infected and colonized patients, especially those admitted to intensive care units (ICUs). A laboratory developed, qualitative duplex real-time polymerase chain reaction assay for rapid detection of OXA-48-like and VIM producing Enterobacteriaceae, performed on rectal swabs, was designed and evaluated in an intensive care unit with endemic presence of OXA-48. During analytical assay validation, no cross-reactivity was observed and 100% sensitivity and specificity were obtained for both blaOXA-48-like and blaVIM in all spiked clinical samples...
April 6, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28442135/-anesthetic-management-of-late-pressure-angioedema
#9
Inês Furtado, Filipe Linda, Sílvia Pica, Marco Monteiro
BACKGROUND AND OBJECTIVES: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. CASE REPORT: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation...
April 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28441316/hemolysis-following-intraoperative-cell-salvage-replacement-in-a-scoliosis-patient-with-sickle-cell-trait-a-case-report
#10
Daniel You, Alejandro Peiro Garcia, Fabio Ferri-de-Barros, David Parsons
STUDY DESIGN: Case Report. OBJECTIVE: To describe a novel presentation of acute renal failure associated with hemolysis following intraoperative cell salvage (ICS) in a neuromuscular scoliosis patient with sickle cell trait (SCT). SUMMARY OF BACKGROUND DATA: Hemolysis associated acute renal failure following ICS in patients with SCT has not been previously reported. Sickle cell disease is regarded as a relative contraindication for ICS due to the risk of red blood cell sickling in the hypoxic cell saver reservoir...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28440898/comparing-induction-of-labour-with-oral-misoprostol-or-foley-catheter-at-term-cost-effectiveness-analysis-of-a-randomised-controlled-multi-centre-non-inferiority-trial
#11
Mieke L G Ten Eikelder, Gert-Jan van Baaren, Katrien Oude Rengerink, Marta Jozwiak, Jan Willem de Leeuw, Gunilla Kleiverda, Inge Evers, Karin de Boer, Josien Brons, Kitty W M Bloemenkamp, Ben W Mol
OBJECTIVE: To assess the costs of labour induction with oral misoprostol compared to Foley catheter. DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Obstetric departments of six tertiary and 23 secondary care hospitals in the Netherlands. POPULATION: Women with a viable term singleton pregnancy in cephalic presentation, intact membranes, an unfavourable cervix (Bishop score <6) without a previous caesarean section, had been randomised for labour induction with oral misoprostol (n = 924) or Foley catheter (n = 921)...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28439999/cost-effectiveness-of-introducing-a-nursing-based-programme-of-ultrasound-guided-peripheral-venous-access-in-a-regional-teaching-hospital
#12
Émilie Gosselin, Johanne Lapré, Stéphan Lavoie, Stéphane Rhein
AIM: To analyse the cost-effectiveness of care provided to patients in need of peripheral venous access by comparing the traditional approach with a nurse-based ultrasound-guided programme. BACKGROUND: Letting nurses insert ultrasound-guided catheters is a promising cost-saving approach, but there are few data available to document the efficiency of this type of programme. METHOD: A cost-efficiency evaluative research design was used. Data were collected over a 6-year timeframe, before and after the implementation of the nurse-based programme...
April 25, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/28438216/improved-pressure-contour-analysis-for-estimating-cardiac-stroke-volume-using-pulse-wave-velocity-measurement
#13
Shun Kamoi, Christopher Pretty, Joel Balmer, Shaun Davidson, Antoine Pironet, Thomas Desaive, Geoffrey M Shaw, J Geoffrey Chase
BACKGROUND: Pressure contour analysis is commonly used to estimate cardiac performance for patients suffering from cardiovascular dysfunction in the intensive care unit. However, the existing techniques for continuous estimation of stroke volume (SV) from pressure measurement can be unreliable during hemodynamic instability, which is inevitable for patients requiring significant treatment. For this reason, pressure contour methods must be improved to capture changes in vascular properties and thus provide accurate conversion from pressure to flow...
April 24, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28436369/treating-male-retention-patients-with-temporary-prostatic-stent-in-a-large-urology-group-practice
#14
Richard M Roach
Men with either chronic or temporary urinary retention symptoms are common patients treated in a urology practice. Both indwelling and intermittent catheterization are widely used to treat this condition. These approaches are associated with significant complications including infection and reduced quality-of-life. Infection is a target for quality improvement and cost reduction strategies in most care settings today. We use a temporary prostatic stent (TPS) to address these issues in our practice. In this report, we describe our approach to patient selection, sizing, placement and follow up of 214 TPS placed in 56 men with chronic or temporary urinary retention in an office setting...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436355/quantification-of-risk-factors-in-500-patients-with-postoperative-urinary-retention
#15
Peter N Tsambarlis, Benjamin A Sherer, Karl F Godlewski, Rebecca M Deal, Jonathan A Myers, Leslie A Deane
INTRODUCTION: An Institutional Quality and Safety Initiative to reduce postoperative urinary retention (POUR) and improve patient safety indicators (PSIs) was undertaken after a nurse driven protocol for catheter removal lead to an increase in POUR. The aim of this study was to identify the number of risk factors present in patients with POUR while examining the prevalence of those risk factors individually. MATERIALS AND METHODS: A retrospective review of our institution's surgical database was performed to identify 500 consecutive cases of POUR between July 1, 2013 and July 1, 2014...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436152/multispecialty-involvement-in-the-management-of-type-b-aortic-dissections-in-the-endovascular-era-implications-for-training-cardiothoracic-residents
#16
Corbin Muetterties, Rohan Menon, William Moser, Nels Carroll, Kathleen Marulanda, Myunghan Choi, Grayson H Wheatley
PURPOSE: Involvement of qualified specialists with proficiency in endovascular therapies has created flux regarding the role of cardiothoracic surgeons, vascular surgeons, and other catheter-skilled specialists in the management of type B aortic dissections. We used manuscript authorship trends and recent match data in order to study how multi-specialty involvement in treating aortic dissections has changed in the endovascular era. METHODS: A PubMed review of published literature between 1998 and 2015 was performed with "aortic dissection" in the title...
April 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28435035/the-expanding-role-of-advanced-practice-providers-in-urologic-procedural-care
#17
Joshua P Langston, Richard Duszak, Venetia L Orcutt, Heather Schultz, Brad Hornberger, Lawrence C Jenkins, Jennifer Hemingway, Danny R Hughes, Raj S Pruthi, Matthew E Nielsen
OBJECTIVE: To understand the role of Advanced Practice Providers (APPs) in urologic procedural care, and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. MATERIALS AND METHODS: Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012...
April 20, 2017: Urology
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#18
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431130/safety-concerns-with-thoracoabdominal-acupuncture-experience-at-a-tertiary-care-emergency-department
#19
Hak Jin Lee, Youn-Jung Kim, Won Young Kim
Objective.:  To evaluate serious complications caused by acupuncture treatment and to increase awareness of this complication. Design.:  A retrospective observational study. Setting. : At the emergency department of a tertiary hospital in an urban area during a five-year period (2010-2014) in Seoul, Korea. Subjects.:  Patients with postacupuncture mechanical complications in the thoracoabdominal region. Methods...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430309/variation-in-use-of-technology-among-vascular-access-specialists-an-analysis-of-the-picc1-survey
#20
Vineet Chopra, Latoya Kuhn, David Ratz, Suzanne Winter, Peter J Carr, David Paje, Sarah L Krein
BACKGROUND: While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings. METHODS: Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement...
April 20, 2017: Journal of Vascular Access
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