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https://www.readbyqxmd.com/read/27903240/central-line-associated-bloodstream-infections-in-a-tertiary-care-children-s-university-hospital-a-prospective-study
#1
Elisabetta Venturini, Carlotta Montagnani, Alessandra Benni, Sabrina Becciani, Klaus Peter Biermann, Salvatore De Masi, Elena Chiappini, Maurizio de Martino, Luisa Galli
BACKGROUND: The central-line associated bloodstream infections (CLABSI) are the most common healthcare-associated infections in childhood. Despite the international data available on healthcare-associated infections in selected groups of patients, there is a lack of large and good quality studies. The present survey is the first prospective study monitoring for 6 months the occurrence of central-line associated bloodstream infections in all departments of an Italian tertiary care children's university hospital...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#2
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27899227/challenges-to-estimating-vaccine-impact-using-hospitalization-data
#3
Cynthia Schuck-Paim, Robert J Taylor, Lone Simonsen, Roger Lustig, Esra Kürüm, Christian A W Bruhn, Daniel M Weinberger
Because the real-world impact of new vaccines cannot be known before they are implemented in national programs, post-implementation studies at the population level are critical. Studies based on analysis of hospitalization rates of vaccine-preventable outcomes are typically used for this purpose. However, estimates of vaccine impact based on hospitalization data are particularly prone to confounding, as hospitalization rates are tightly linked to changes in the quality, access and use of the healthcare system, which often occur simultaneously with introduction of new vaccines...
November 26, 2016: Vaccine
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#4
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27886039/use-of-personal-digital-assistants-to-detect-healthcare-associated-infections-in-a-neonatal-intensive-care-unit-in-egypt
#5
Elham Am El-Feky, Doa'a A Saleh, Jehan El-Kholy, Ahmed Mahmoud Sayed, Yasmeen Mansi, Mohamed Hashem
INTRODUCTION: Personal digital assistants (PDAs) used in electronic laboratory-based surveillance are a promising alternative to conventional surveillance to detect healthcare-associated infections (HAIs). The aim of the study was to monitor, detect, and analyze HAIs using PDAs in a neonatal intensive care unit (NICU). METHODOLOGY: In this descriptive study, 1,053 neonates admitted to the NICU in the obstetrics and gynecology ward at the Cairo University hospital were included and evaluated for HAIs by collecting data using PDAs programmed by Naval Medical Research Unit 3, Cairo, with the definitions for HAIs provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention...
November 24, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27884325/violet-405-nm-light-a-novel-therapeutic-agent-against-common-pathogenic-bacteria
#6
Mitchell D Barneck, Nathaniel L R Rhodes, Martin de la Presa, James P Allen, Ahrash E Poursaid, Maziar M Nourian, Matthew A Firpo, John T Langell
BACKGROUND: The increasing incidence of healthcare-associated infections (HAIs) and multidrug-resistant organisms demonstrate the need for innovative technological solutions. Staphylococcus aureus, Streptococcus pneumonia, Escherichia coli, and Pseudomonas aeruginosa in particular are common pathogens responsible for a large percentage of indwelling medical device-associated clinical infections. The bactericidal effects of visible light sterilization (VLS) using 405-nm is one potential therapeutic under investigation...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#7
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27871233/a-retrospective-analysis-of-melioidosis-in-cambodian-children-2009-2013
#8
Paul Turner, Sabine Kloprogge, Thyl Miliya, Sona Soeng, Pisey Tan, Poda Sar, Pagnarith Yos, Catrin E Moore, Vanaporn Wuthiekanun, Direk Limmathurotsakul, Claudia Turner, Nicholas P J Day, David A B Dance
BACKGROUND: Melioidiosis, infection by Burkholderia pseudomallei, is an important but frequently under-recognised cause of morbidity and mortality in Southeast Asia and elsewhere in the tropics. Data on the epidemiology of paediatric melioidosis in Cambodia are extremely limited. METHODS: Culture-positive melioidosis cases presenting to Angkor Hospital for Children, a non-governmental paediatric hospital located in Siem Reap, Northern Cambodia, between 1(st) January 2009 and 31(st) December 2013 were identified by searches of hospital and laboratory databases and logbooks...
November 21, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27862739/variability-of-respiratory-rate-measurements-in-children-suspected-with-non-severe-pneumonia-in-north-east-tanzania
#9
Florida Muro, Neema Mosha, Helena Hildenwall, Frank Mtei, Nicole Harrison, David Schellenberg, Raimos Olomi, Hugh Reyburn, Jim Todd
OBJECTIVE: Measurement of respiratory rate is an important clinical sign in the diagnosis of pneumonia but suffers from inter-observer variation. Here we assess the use of video recordings as a quality assurance tool that could be useful both in research and in training of staff. METHODS: Respiratory rates (RR) were recorded in children aged 2 - 59 months presenting with cough or difficulty breathing at two busy outpatient clinics in Tanzania. Measurements were repeated at 10-minute intervals in a quiet environment with simultaneous video recordings that were independently reviewed by two paediatricians...
November 14, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27848189/the-impact-of-disability-and-social-determinants-of-health-on-condition-specific-readmissions-beyond-medicare-risk-adjustments-a-cohort-study
#10
Jennifer Meddings, Heidi Reichert, Shawna N Smith, Theodore J Iwashyna, Kenneth M Langa, Timothy P Hofer, Laurence F McMahon
BACKGROUND: Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. OBJECTIVE: To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP)...
November 15, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27843770/cost-effectiveness-analysis-of-heat-and-moisture-exchangers-in-mechanically-ventilated-critically-ill-patients
#11
Mayra Goncalves Menegueti, Maria Auxiliadora-Martins, Altacilio Aparecido Nunes
BACKGROUND: Moisturizing, heating and filtering gases inspired via the mechanical ventilation (MV) circuits help to reduce the adverse effects of MV. However, there is still no consensus regarding whether these measures improve patient prognosis, shorten MV duration, decrease airway secretion and lower the incidence of ventilator associated pneumonia (VAP) and other complications. OBJECTIVES: The aim of this study was to study the incremental cost-effectiveness ratio associated with the use of heat and moisture exchangers (HME) filter to prevent VAP compared with the heated humidifiers (HH) presently adopted by intensive care unit (ICU) services within the Brazilian Healthcare Unified System...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27821953/effect-of-exercise-therapy-on-cytokine-secretion-in-the-saliva-of-bedridden-patients
#12
Hidemasa Iki, Shunji Sawa, Toshio Teranishi, Masao Tomita, Kazuhiro Nishii, Kouji Yamada
[Purpose] The number of bedridden patients requiring nursing care in Japan has increased sharply in recent years because of its aging population and advances in medical care and has become a major social issue. Because bedridden patients are susceptible to nursing and healthcare-associated pneumonia, it is very important to improve their immunocompetence. Therefore, the effect of exercise therapy on stimulation of cytokine secretion in the saliva of bedridden patients was investigated. [Subjects and Methods] The subjects of this study were bedridden patients admitted to nursing care facilities...
October 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27810315/cost-effectiveness-analysis-of-pneumococcal-vaccination-for-infants-in-china
#13
Kristin A Maurer, Huey-Fen Chen, Abram L Wagner, Sonia T Hegde, Tejasi Patel, Matthew L Boulton, David W Hutton
BACKGROUND: Although China has a high burden of pneumococcal disease among young children, the government does not administer publicly-funded pneumococcal conjugate vaccines (PCV) through its Expanded Program on Immunization (EPI). We evaluated the cost-effectiveness of publicly-funded PCV-7, PCV-10, and PCV-13 vaccination programs for infants in China. METHODS: Using a Markov model, we simulated a cohort of 16 million Chinese infants to estimate the impact of PCV-7, PCV-10, and PCV-13 vaccination programs from a societal perspective...
December 7, 2016: Vaccine
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#14
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27776648/comparison-of-image-quality-and-visibility-of-normal-and-abnormal-findings-at-submillisievert-chest-ct-using-filtered-back-projection-iterative-model-reconstruction-imr-and-idose-4-%C3%A2
#15
Azien Laqmani, Maxim Avanesov, Sebastian Butscheidt, Maximilian Kurfürst, Susanne Sehner, Jakob Schmidt-Holtz, Thorsten Derlin, Cyrus Behzadi, Hans D Nagel, Gerhard Adam, Marc Regier
OBJECTIVE: To compare both image quality and visibility of normal and abnormal findings at submillisievert chest CT (smSv-CT) using filtered back projection (FBP) and the two different iterative reconstruction (IR) techniques iterative model reconstruction (IMR) and iDose(4)™. MATERIALS AND METHODS: This institutional review board approved study was based on retrospective interpretation of clinically indicated acquired data. The requirement to obtain informed consent was waived...
November 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27772529/does-ventilator-associated-event-surveillance-detect-ventilator-associated-pneumonia-in-intensive-care-units-a-systematic-review-and-meta-analysis
#16
Yunzhou Fan, Fang Gao, Yanyan Wu, Jie Zhang, Ming Zhu, Lijuan Xiong
BACKGROUND: Ventilator-associated event (VAE) is a new surveillance paradigm for monitoring complications in mechanically ventilated patients in intensive care units (ICUs). The National Healthcare Safety Network replaced traditional ventilator-associated pneumonia (VAP) surveillance with VAE surveillance in 2013. The objective of this study was to assess the consistency between VAE surveillance and traditional VAP surveillance. METHODS: We systematically searched electronic reference databases for articles describing VAE and VAP in ICUs...
October 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27770536/important-aspect-of-health-care-associated-infections-in-georgia-with-the-focus-on-ventilator-associated-pneumonia-review
#17
T Akhvlediani, N Akhvlediani, T Kuchuloria
Health care associated infections are the most frequent adverse event accompanying healthcare delivery worldwide. Of these, respiratory tract infections, including ventilator-associated pneumonia (VAP), have been recognized as the most common infections in acute hospitals. Sparse anecdotal and epidemiologic data from intensive care units (ICU) and infectious diseases physicians, as well as several publications in this field, suggest that the etiology of VAP in Georgia is most likely Klebsiella pneumoniae. This review article discusses the challenges of infection control in the Georgian health care system, with a focus on VAP...
September 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27768654/measuring-patient-safety-the-medicare-patient-safety-monitoring-system-past-present-and-future
#18
David C Classen, William Munier, Nancy Verzier, Noel Eldridge, David Hunt, Mark Metersky, Chesley Richards, Yun Wang, P Jeffrey Brady, Amy Helwig, James Battles
The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system. After more than 10 years, one of those federal programs, the Medicare Patient Safety Monitoring System (MPSMS), has reached a level of maturity and stability that has made it useful for the consistent measurement of the safety of inpatient care...
October 20, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27763576/prevention-of-respiratory-insufficiency-after-surgical-management-prism-trial-report-of-the-protocol-for-a-pragmatic-randomised-controlled-trial-of-continuous-positive-airway-pressure-cpap-to-prevent-respiratory-complications-and-improve-survival-following
#19
Rupert M Pearse, Tom E Abbott, Richard Haslop, Tahania Ahmad, Brennan C Kahan, Claudia Filipini, Andrew Rhodes, Marco Ranieri
BACKGROUND: Over 300 million patients undergo surgery worldwide each year. Postoperative morbidity - particularly respiratory complications - are most frequent and severe among high-risk patients undergoing major abdominal surgery. However, standard treatments, like physiotherapy or supplemental oxygen, often fail to prevent these. Preliminary research suggests that prophylactic continuous positive airways pressure (CPAP) can reduce the risk of postoperative respiratory complications...
October 20, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27759619/infectious-surgical-complications-are-not-dichotomous-characterizing-discordance-between-administrative-data-and-registry-data
#20
David A Etzioni, Cynthia L Lessow, Heather D Lucas, Amit Merchea, James A Madura, Raman Mahabir, Nitin Mishra, Nabil Wasif, Amit K Mathur, Yu-Hui H Chang, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: To characterize reasons for discordance between administrative data and registry data in the determination of postoperative infectious complications. BACKGROUND: Data regarding the occurrence of postoperative surgical complications are identified through either administrative or registry data. Rates of complications vary significantly between these two types of data; the reasons for this are not well-understood. METHODS: The occurrence of 30-day inpatient infectious complications (pneumonia, sepsis, surgical site infection, and urinary tract infection) was compared between the NSQIP and administrative mechanisms at 4 academic hospitals between 2012 and 2014...
October 17, 2016: Annals of Surgery
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