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https://www.readbyqxmd.com/read/28538044/mycobacterium-chimaera-infections-associated-with-heater-cooler-units-in-cardiac-surgery
#1
Peter W Schreiber, Hugo Sax
PURPOSE OF REVIEW: Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater-cooler units (HCUs) have been published. This review summarizes the current knowledge. RECENT FINDINGS: M...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28532976/microbiological-problems-and-biofilms-associated-with-mycobacterium-chimaera-in-heater-cooler-units-used-for-cardiopulmonary-bypass
#2
REVIEW
J Walker, G Moore, S Collins, S Parks, M I Garvey, T Lamagni, G Smith, L Dawkin, S Goldenberg, M Chand
The role of heater-cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognized since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of micro-organisms, including M...
July 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28473009/a-year-in-the-life-of-a-contaminated-heater-cooler-unit-with-mycobacterium-chimaera
#3
Mark I Garvey, Craig W Bradley, Jimmy Walker
OBJECTIVE Heater-cooler units (HCUs) have been shown to be a source of Mycobacterium chimaera infections. For the past year, weekly water samples have been taken from HCUs used at University Hospitals Birmingham (UHB) NHS Foundation Trust. We report the microbial contamination of the HCUs over a year detailing the decontamination regimes applied at UHB to reduce the microbial load. DESIGN Observational study SETTING UHB is a tertiary referral teaching hospital in Birmingham, United Kingdom, that provides clinical services to nearly 1 million patients every year...
May 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28385672/characterization-of-health-care-utilization-in-patients-receiving-implantable-cardioverter-defibrillator-therapies-an-analysis-of-the-managed-ventricular-pacing-trial
#4
John Rickard, David Whellen, Lou Sherfesee, Brett J Peterson, Tara Nahey, Anthony S Tang, Kenneth A Ellenbogen, Alan Cheng
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are effective in terminating lethal arrhythmias, but little is known about the degree of health care utilization (HCU) after ICD therapies. OBJECTIVE: Using data from the managed ventricular pacing trial, we sought to identify the incidence and types of HCU in ICD recipients after receiving ICD therapy (shocks or antitachycardia pacing [ATP]). METHODS: We analyzed HCU events (ventricular tachyarrhythmia [VTA]-related, heart failure-related, ICD implant procedure-related, ICD system-related, or other) and their association with ICD therapies (shocked ventricular tachycardia episode, ATP-terminated ventricular tachycardia episode, and inappropriately shocked episode)...
April 4, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28291718/cystathionine-beta-synthase-deficiency-alters-hepatic-phospholipid-and-choline-metabolism-post-translational-repression-of-phosphatidylethanolamine-n-methyltransferase-is-a-consequence-rather-than-a-cause-of-liver-injury-in-homocystinuria
#5
René L Jacobs, Hua Jiang, John P Kennelly, David J Orlicky, Robert H Allen, Sally P Stabler, Kenneth N Maclean
Classical homocystinuria (HCU) due to inactivating mutation of cystathionine β-synthase (CBS) is a poorly understood life-threatening inborn error of sulfur metabolism. A previously described cbs-/- mouse model exhibits a semi-lethal phenotype due to neonatal liver failure. The transgenic HO mouse model of HCU exhibits only mild liver injury and recapitulates multiple aspects of the disease as it occurs in humans. Disruption of the methionine cycle in HCU has the potential to impact multiple aspect of phospholipid (PL) metabolism by disruption of both the Kennedy pathway and phosphatidylethanolamine N-methyltransferase (PEMT) mediated synthesis of phosphatidylcholine (PC)...
March 2, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28196927/healthcare-utilization-and-expenditures-associated-with-appropriate-and-inappropriate-implantable-defibrillator-shocks
#6
Mintu P Turakhia, Steven Zweibel, Andrea L Swain, Sarah A Mollenkopf, Matthew R Reynolds
BACKGROUND: In patients with implantable cardioverter-defibrillators, healthcare utilization (HCU) and expenditures related to shocks have not been quantified. METHODS AND RESULTS: We performed a retrospective cohort study of patients with implantable cardioverter-defibrillators identified from commercial and Medicare supplemental claims databases linked to adjudicated shock events from remote monitoring data. A shock event was defined as ≥1 spontaneous shocks delivered by an implanted device...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28103865/can-healthcare-utilization-data-reliably-capture-cases-of-chronic-respiratory-diseases-a-cross-sectional-investigation-in-italy
#7
A Biffi, R Comoretto, A Arfè, L Scotti, L Merlino, A Vaghi, A Pesci, R de Marco, G Corrao
BACKGROUND: Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed...
January 19, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28035898/mycobacterium-chimaera-in-heater-cooler-units-in-denmark-related-to-isolates-from-the-united-states-and-united-kingdom
#8
Erik Svensson, Elsebeth Tvenstrup Jensen, Erik Michael Rasmussen, Dorte Bek Folkvardsen, Anders Norman, Troels Lillebaek
Mycobacterium chimaera was present at high rates (>80%) in heater-cooler units (HCUs) from all 5 thoracic surgery departments in Denmark. Isolates were clonal to HCU-associated isolates from the United States (including some from patients) and United Kingdom. However, M. chimaera from 2 brands of HCU were genetically distinct.
March 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28033198/assessment-of-biopsychosocial-complexity-and-health-care-needs-measurement-properties-of-the-intermed-self-assessment-version
#9
Arianne K B van Reedt Dortland, Lilian L Peters, Annette D Boenink, Jan H Smit, Joris P J Slaets, Adriaan W Hoogendoorn, Andreas Joos, Corine H M Latour, Friedrich Stiefel, Cyrille Burrus, Marie Guitteny-Collas, Silvia Ferrari
OBJECTIVE: The INTERMED Self-Assessment questionnaire (IMSA) was developed as an alternative to the observer-rated INTERMED (IM) to assess biopsychosocial complexity and health care needs. We studied feasibility, reliability, and validity of the IMSA within a large and heterogeneous international sample of adult hospital inpatients and outpatients as well as its predictive value for health care use (HCU) and quality of life (QoL). METHODS: A total of 850 participants aged 17 to 90 years from five countries completed the IMSA and were evaluated with the IM...
May 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28003776/chronic-abdominal-pain-in-children-and-adolescents-parental-threat-perception-plays-a-major-role-in-seeking-medical-consultations
#10
Claudia Calvano, Petra Warschburger
Background. Pain symptoms, associated impairment, and parental perception of threat are reported to be predictors of health care utilization (HCU) in childhood chronic abdominal pain (CAP). However, mediating variables and their interrelations have not yet been systematically studied. Objectives. This study aims to identify mediating pathways of influence between child's abdominal pain and the number of pain-related medical visits. Methods. In a multicenter study, we recruited N = 151 parent-child dyads with children aged 6-17 years suffering from CAP...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27918263/mycobacterium-chimaera-colonisation-of-heater-cooler-units-hcu-in-western-australia-2015-investigation-of-possible-iatrogenic-infection-using-whole-genome-sequencing
#11
James Owen Robinson, Geoffrey Wallace Coombs, David John Speers, Terillee Keehner, Anthony David Keil, Victoria D'Abrera, Peter Boan, Stanley Pang
Following the reported link between heater-cooler unit (HCU) colonisation with Mycobacterium chimaera and endocarditis, mycobacterial sampling of all HCUs in use in Western Australia was initiated from August 2015, revealing M. chimaera colonisation in 10 of 15 HCUs. After M. chimaera was isolated from a pleural biopsy from a cardiothoracic patient who may have been exposed to a colonised HCU, a whole genome sequencing investigation was performed involving 65 specimens from 15 HCUs across five hospitals to assess if this infection was related to the HCU...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27918256/mycobacterium-chimaera-infections-associated-with-heater-cooler-units-hcu-closing-another-loophole-in-patient-safety
#12
EDITORIAL
Marc J Struelens, Diamantis Plachouras
No abstract text is available yet for this article.
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27704025/patterns-of-healthcare-utilization-among-veterans-infected-with-hepatitis-c-virus-hcv-and-human-immunodeficiency-virus-hiv-and-coinfected-with-hiv-hcv-unique-burdens-of-disease
#13
Shereen Katrak, Lawrence P Park, Christopher Woods, Andrew Muir, Charles Hicks, Susanna Naggie
Background.  Hepatitis C virus (HCV) infection is a leading cause of cirrhosis and the primary cause of liver transplantation in the United States, and coinfection with human immunodeficiency virus (HIV) increases the risk of comorbidities. However, healthcare utilization (HCU) patterns among HIV/HCV-coinfected patients are poorly understood. This study compared the rates of HCU and reasons for hospital admission among HCV-infected, HIV-infected, and HIV/HCV-coinfected veterans. Methods.  Hepatitis C virus- and HIV-infected and HIV/HCV-coinfected veterans in care with the Department of Veterans Affairs (VA) from 1998 to 2009 (n = 335 371, n = 28 179, n = 13 471, respectively) were identified by HIV- and HCV-associated International Classification of Diseases, Ninth Revision codes from the clinical case registry...
September 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27472686/hand-carried-ultrasound-use-in-clinical-nephrology-case-report
#14
Kathryn D Winters, Stephanie Toth-Manikowski, Carol Martire, Tariq Shafi
BACKGROUND: Correctly assessing and managing volume status are critical elements of daily care for patients managed by nephrologists. However, intravascular volume is difficult to assess by physical examination alone. METHODS: We present vignettes illustrating the potential for using hand-carried ultrasound (HCU) to improve volume assessment in common clinical scenarios faced by the renal consultant in the hospital setting. These include patients with acute kidney injury and patients treated with hemodialysis...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27445595/healthcare-use-for-pain-in-women-waiting-for-gynaecological-surgery
#15
Sarah Walker, Wilma M Hopman, Meg E Carley, Elizabeth G Mann, Elizabeth G VanDenKerkhof
Background. Pain while waiting for surgery may increase healthcare utilization (HCU) preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n = 360) reported a total of 2026 healthcare visits, with 21% (n = 126) reporting six or more visits in the year before surgery...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27444187/telehealth-clinics-increase-access-to-care-for-adults-with-cystic-fibrosis-living-in-rural-and-remote-western-australia
#16
Jamie Wood, Siobhain Mulrennan, Kylie Hill, Nola Cecins, Sue Morey, Sue Jenkins
INTRODUCTION: A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. METHODS: Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention...
July 20, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27429771/enhanced-antimicrobial-peptide-induced-activity-in-the-mollusc-toll-2-family-through-evolution-via-tandem-toll-interleukin-1-receptor
#17
Jun Cao, Yihong Chen, Min Jin, Qian Ren
Toll receptors play an important role in the innate immunity of invertebrates. All reported Tolls have only one Toll/interleukin-1 receptor (TIR) domain at the C-terminal. In this study, numerous Tolls with tandem TIRs at the C-terminal were found in molluscs. Such Tolls presented an extra TIR (TIR-1) compared with Toll-I. Thus, Toll-I might be the ancestor of tandem TIRs containing Toll. To test this hypothesis, 83 Toll-I and Toll-2 (most have two TIRs, but others seem to be the evolutionary intermediates) genes from 29 shellfish species were identified...
June 2016: Royal Society Open Science
https://www.readbyqxmd.com/read/27404977/sociodemographic-and-access-related-correlates-of-health-care-utilization-among-african-american-injection-drug-users-the-besure-study
#18
Allysha C Maragh-Bass, Christine Powell, Ju Park, Colin Flynn, Danielle German
Persons who inject drugs (PWID) may have less access to, and utilization of, health-care services, and African American PWID may be less likely than other racial groups to utilize health care in the United States. The present study evaluated the prevalence of health-care utilization (HCU) among a cohort of African American PWID in Baltimore. Data were from the 2012 Baltimore National HIV Behavioral Surveillance study. Participants were adult PWID and recruited using respondent-driven sampling (RDS). They completed a comprehensive sociobehavioral survey and voluntary HIV test with trained study interviewers...
July 12, 2016: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/27338198/a-1-day-visit-in-a-severe-asthma-centre-effect-on-asthma-control-quality-of-life-and-healthcare-use
#19
Akke-Nynke van der Meer, Henk Pasma, Wilma Kempenaar-Okkema, Jo-Anneke Pelinck, Myrte Schutten, Huib Storm, Anneke Ten Brinke
Patients with uncontrolled asthma report ongoing symptoms, poor quality-of-life and extensive healthcare use (HCU) and might benefit from management by a specialised severe asthma team. It is unknown whether a one-time evaluation by asthma experts, without long-term supervision by a specialised team, provides favourable outcomes. We evaluated asthma control (Asthma Control Questionnaire; ACQ), quality-of-life (Asthma-related Quality of Life Questionnaire; AQLQ) and HCU before and 1 year after a 1-day visit programme in a severe asthma centre, including a multidisciplinary assessment resulting in a personalised management plan to be implemented by patients own pulmonologists...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27325427/newborn-screening-for-vitamin-b6-non-responsive-classical-homocystinuria-systematical-evaluation-of-a-two-tier-strategy
#20
Jürgen G Okun, Hongying Gan-Schreier, Tawfeq Ben-Omran, Kathrin V Schmidt, Junmin Fang-Hoffmann, Gwendolyn Gramer, Ghassan Abdoh, Noora Shahbeck, Hilal Al Rifai, Abdul Latif Al Khal, Gisela Haege, Chuan-Chi Chiang, David C Kasper, Bridget Wilcken, Peter Burgard, Georg F Hoffmann
BACKGROUND: In classical homocystinuria (HCU, MIM# 236200) due to the deficiency of cystathionine β-synthase (EC 4.2.1.22) there is a clear evidence for the success of early treatment. The aim of this study was to develop and evaluate a two-tier strategy for HCU newborn screening. METHODS: We reevaluated data from our newborn screening programme for Qatar in a total number of 125,047 neonates including 30 confirmed HCU patients. Our hitherto existing screening strategy includes homocysteine (Hcy) measurements in every child, resulting in a unique dataset for evaluation of two-tier strategies...
2017: JIMD Reports
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