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https://www.readbyqxmd.com/read/28941393/mobile-health-application-to-assist-doctors-in-antibiotic-prescription-an-approach-for-antibiotic-stewardship
#1
Felipe Francisco Tuon, Juliano Gasparetto, Luciana Cristina Wollmann, Thyago Proença de Moraes
BACKGROUND: Technologies applied to mobile devices can be an important strategy in antibiotic stewardship programs. OBJECTIVE: The aim of this study was to determine the impact of a decision-making application on antibiotic prescription. METHODS: This was an observational, analytical and longitudinal study on the implementation of an antimicrobial guide for mobile application (app). This study analyzed the period of 12 months before and 12 months after the app implementation at a university hospital based on local epidemiology, avoiding high cost drugs and reducing the potential for drug resistance including carbapenem...
September 20, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28938307/design-and-development-of-a-miniaturized-percutaneously-deployable-wireless-left-ventricular-assist-device-early-prototypes-and-feasibility-testing
#2
Brian Letzen, Jiheum Park, Zeynep Tuzun, Pramod Bonde
The current left ventricular assist devices (LVADs) are limited by a highly invasive implantation procedure in a severely unstable group of advanced heart failure patients. Additionally, the current transcutaneous power drive line acts as a nidus for infection resulting in significant morbidity and mortality. In an effort to decrease this invasiveness and eliminate drive line complications, we have conceived a wireless miniaturized percutaneous LVAD, capable of being delivered endovascularly with a tether-free operation...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#3
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28935351/impact-of-left-ventricular-assist-device-related-complications-on-posttransplant-graft-survival
#4
Dhaval Chauhan, Alexis K Okoh, Setri Fugar, Rivandra Karanam, David Baran, Mark Zucker, Magarita Camacho, Mark J Russo
BACKGROUND: This study describes the impact of continuous-flow left-ventricular-assist device (CF-LVAD)-related complications on postoperative outcomes. METHODS: The United Network for Organ Sharing (UNOS) heart transplant follow-up data from 2005 to 2015 were obtained. CF-LVAD patients who were bridged to transplant were studied. Device-related complications (DRCs) at patient's last follow-up before transplantation were reported in 5 categories: device thrombosis (B1), infection (B2), device malfunction (B3), life-threatening arrhythmias (B4), and others (B5)...
September 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28934914/new-concept-of-3d-printed-bone-clip-polylactic-acid-hydroxyapatite-silk-composite-for-internal-fixation-of-bone-fractures
#5
Yeung Kyu Yeon, Hae Sang Park, Jung Min Lee, Ji Seung Lee, Young Jin Lee, Md Tipu Sultan, Ye Bin Seo, Ok Joo Lee, Soon Hee Kim, Chan Hum Park
Open reduction with internal fixation is commonly used for the treatment of bone fractures. However, postoperative infection associated with internal fixation devices (intramedullary nails, plates, and screws) remains a significant complication, and it is technically difficult to fix multiple fragmented bony fractures using internal fixation devices. In addition, drilling in the bone to install devices can lead to secondary fracture, bone necrosis associated with postoperative infection. In this study, we developed bone clip type internal fixation device using three- dimensional (3D) printing technology...
September 22, 2017: Journal of Biomaterials Science. Polymer Edition
https://www.readbyqxmd.com/read/28934879/two-year-evaluation-of-osteochondral-repair-with-a-novel-biphasic-graft-saturated-in-bone-marrow-in-an-equine-model
#6
Taralyn M McCarrel, Sarah L Pownder, Susannah Gilbert, Matthew F Koff, Emme Castiglione, Ryan A Saska, Gino Bradica, Lisa A Fortier
Objective To evaluate a biphasic cartilage repair device (CRD) for feasibility of arthroscopic implantation, safety, biocompatibility, and efficacy for long-term repair of large osteochondral defects. Methods The CRD was press-fit into defects (10 mm diameter, 10 mm deep) created in the femoral trochlea of 12 horses. In the contralateral limb, 10 mm diameter full-thickness chondral defects were treated with microfracture (MFX). Radiographs were obtained pre- and postoperatively, and at 4, 12, and 24 months...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28933249/anesthetic-management-of-laser-lead-extraction-for-cardiovascular-implantable-electronic-devices
#7
Meena Bhatia, Payam Safavi-Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28931801/elizabethkingia-meningoseptica-in-a-case-of-biliary-tract-infection-following-liver-transplantation
#8
Hebah M Musalem, Yazan N Honjol, Lin M Tuleimat, Saleh I Al Abbad, Fahad I Alsohaibani
BACKGROUND Elizabethkingia meningoseptica (E. meningoseptica) is an aerobic Gram-negative bacillus known to thrive in moist environments, and is now recognized as a hospital-acquired infection, being found to contaminate hospital equipment, respiratory apparatus, hospital solutions, water, and drainage systems. Nosocomial infection with E. meningoseptica occurs in immunocompromised patients, requires specialized identification methods, and is resistant to conventional antibiotics. We report a case of E. meningoseptica infection arising from a percutaneous transhepatic biliary drainage (PTBD) tube...
September 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#9
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28931072/high-prevalence-of-non-dipping-blood-pressure-and-vascular-stiffness-in-hiv-infected-south-africans-on-antiretrovirals
#10
M S Borkum, J M Heckmann, K Manning, J A Dave, N S Levitt, B L Rayner, N Wearne
BACKGROUND: HIV-infected individuals are at increased risk of tissue inflammation and accelerated vascular aging ('inflamm-aging'). Abnormal diurnal blood pressure (BP) rhythms such as non-dipping may contribute to an increased risk of cardiovascular and cerebrovascular events in HIV infected individuals. However, little data exists on ambulatory blood pressure (ABP) and measures of vascular stiffness in the black African HIV infected population. METHODS: This is a cross-sectional analysis of otherwise well, HIV infected outpatients on ART for >5 years...
2017: PloS One
https://www.readbyqxmd.com/read/28930905/effectiveness-of-early-warming-with-self-warming-blankets-on-postoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#11
Baris B Koc, Martijn G M Schotanus, Jean-Paul A P A C Kollenburg, Maurice J A Janssen, Fabian Tijssen, Edwin J P Jansen
BACKGROUND: Hypothermia is an important complication in joint arthroplasty. Commonly, forced air warming (FAW) devices are used intraoperatively to maintain body temperature in patients undergoing surgery. However, it is believed that these convective warming systems could increase the risk of deep surgical site infections due to disruption of unidirectional downward laminar airflow. Conductive warming devices have no noticeable effect on ventilation airflow. Nevertheless, the effectiveness of the self-warming (SW) blanket, a novel conductive warming device, on postoperative hypothermia in elective joint arthroplasty is unknown...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930641/face-masks-and-cough-etiquette-reduce-the-cough-aerosol-concentration-of-pseudomonas-aeruginosa-in-people-with-cystic-fibrosis
#12
Michelle E Wood, Rebecca E Stockwell, Graham R Johnson, Kay A Ramsay, Laura J Sherrard, Nassib Jabbour, Emma Ballard, Peter O'Rourke, Timothy J Kidd, Claire E Wainwright, Luke D Knibbs, Peter D Sly, Lidia Morawska, Scott C Bell
RATIONALE: People with cystic fibrosis (CF) generate Pseudomonas aeruginosa in droplet nuclei during coughing. The use of surgical masks has been recommended in healthcare settings to minimise pathogen transmission between CF patients. OBJECTIVE: To determine if face masks and cough etiquette reduce viable P. aeruginosa aerosolised during cough. METHODS: Twenty-five adults with CF and chronic P. aeruginosa infection were recruited. Participants performed six talking and coughing maneuvers, with or without face masks (surgical and N95) and hand covering the mouth when coughing (cough etiquette) in an aerosol-sampling device...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28928941/computational-design-of-molecular-motors-as-nanocircuits-in-leishmaniasis
#13
Dipali Kosey, Shailza Singh
Cutaneous leishmaniasis is the most common form of lesihmaniasis, caused by Leishmania major and is spread by the bite of a sandfly .This species infects the macrophages and dendritic cells Due to multi-drug resistance, there is a need for a new therapeutic technique. Recently, a novel molecular motor of Leishmania, Myosin XXI, was classified and characterized. In addition, the drug resistance in this organism has been linked with the overexpression of ABC transporters. Systems biology aims to study the simulation and modeling of natural biological systems whereas synthetic biology deals with building novel and artificial biological parts and devices  Together they have contributed enormously to drug discovery, vaccine design and development, infectious disease detection and diagnostics...
2017: F1000Research
https://www.readbyqxmd.com/read/28928258/implantable-cardiac-defibrillator-infections-the-emerging-importance-of-mycobacterium-fortuitum
#14
Menfil Orellana-Barrios, David A Sotello Aviles, Olusegun Oyenuga, Kenneth Nugent
Infection is a clinically relevant complication associated with intracardiac devices. Atypical mycobacteria, particularly Mycobacterium fortuitum, have been increasingly implicated in cardiovascular implantable electronic device (CIED) infections. We present a case of M. fortuitum CIED infection in a patient with ischaemic cardiomyopathy occurring approximately 3 weeks after insertion. The recognition and adequate treatment, including device removal, tissue sampling and the determination of antimicrobial sensitivities, are essential in the proper management of these patients...
September 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28927475/impact-of-discontinuing-contact-precautions-for-mrsa-and-esble-in-an-intensive-care-unit-a-prospective-noninferiority-before-and-after-study
#15
Laurie Renaudin, Mathieu Llorens, Christophe Goetz, Sébastien Gette, Vincente Citro, Sylvia Poulain, Marie-Laure Vanson, Jocelyne Sellies
OBJECTIVE To compare incidence densities of methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE) acquisition in the intensive care unit (ICU) before and after discontinuation of contact precautions (CP) and application of standard precautions (SP). DESIGN Prospective noninferiority before-and-after study comparing 2 periods: January 1, 2012, to January 31, 2014 (the CP period) and February 1, 2014, to February 29, 2016 (the SP period). SETTING A 16-bed polyvalent ICU in France with only single-bed rooms with dedicated equipment and reusable medical devices...
September 20, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28924724/development-of-a-high-throughput-magnetic-separation-device-for-malaria-infected-erythrocytes
#16
A Blue Martin, Wei-Tao Wu, Marina V Kameneva, James F Antaki
This study describes a non-dilutive high-gradient magnetic separation (HGMS) device intended to continuously remove malaria-infected red blood cells (iRBCs) from the circulation. A mesoscale prototype device with disposable photo-etched ferromagnetic grid and reusable permanent magnet was designed with a computationally-optimized magnetic force. The prototype device was evaluated in vitro using a non-pathogenic analog for malaria-infected blood, comprised of 24% healthy RBCs, 6% human methemoglobin RBCs (metRBCs), and 70% phosphate buffer solution (PBS)...
September 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28924069/-a-case-of-transoral-penetrating-head-injury-from-a-crossbow-fired-arrow
#17
Naoto Nakamura, Yuichi Fujita, Satoshi Nakamizo, Yoshio Sakagami, Ken Okazaki, Kouta Kida
Penetrating head injuries are extremely rare in Japan. The authors describe a case involving a penetrating head injury from an arrow fired from a crossbow. A 52-year-old man who had shot himself transorally in a suicide attempt was admitted to the authors' hospital. On admission, he was conscious and exhibited no neurological deficits. The end of the arrow was visible inside his oral cavity. Computed tomography revealed the arrow had penetrated the right cerebellum and occipital lobe, resulting in a very small hematoma...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28923118/hypothermia-for-encephalopathy-in-low-and-middle-income-countries-helix-study-protocol-for-a-randomised-controlled-trial
#18
Sudhin Thayyil, Vania Oliveira, Peter J Lally, Ravi Swamy, Paul Bassett, Mani Chandrasekaran, Jayashree Mondkar, Sundaram Mangalabharathi, Naveen Benkappa, Arasar Seeralar, Mohammod Shahidullah, Paolo Montaldo, Jethro Herberg, Swati Manerkar, Kumutha Kumaraswami, Chinnathambi Kamalaratnam, Vinayagam Prakash, Rema Chandramohan, Prathik Bandya, Mohammod Abdul Mannan, Ranmali Rodrigo, Mohandas Nair, Siddarth Ramji, Seetha Shankaran
BACKGROUND: Therapeutic hypothermia reduces death and disability after moderate or severe neonatal encephalopathy in high-income countries and is used as standard therapy in these settings. However, the safety and efficacy of cooling therapy in low- and middle-income countries (LMICs), where 99% of the disease burden occurs, remains unclear. We will examine whether whole body cooling reduces death or neurodisability at 18-22 months after neonatal encephalopathy, in LMICs. METHODS: We will randomly allocate 408 term or near-term babies (aged ≤ 6 h) with moderate or severe neonatal encephalopathy admitted to public sector neonatal units in LMIC countries (India, Bangladesh or Sri Lanka), to either usual care alone or whole-body cooling with usual care...
September 18, 2017: Trials
https://www.readbyqxmd.com/read/28919748/antibacterial-properties-of-pekk-for-orthopedic-applications
#19
Mian Wang, Garima Bhardwaj, Thomas J Webster
Orthopedic implant infections have been steadily increasing while, at the same time, antibiotics developed to kill such bacteria have proven less and less effective with every passing day. It is clear that new approaches that do not rely on the use of antibiotics are needed to decrease medical device infections. Inspired by cicada wing surface topographical features, nanostructured surfaces represent a new approach for imposing antibacterial properties to biomaterials without using drugs. Moreover, new chemistries with altered surface energetics may decrease bacterial attachment and growth...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28918972/-mycological-and-parasitological-examinations-in-the-management-of-lung-infections
#20
REVIEW
L Lachaud, J P Gangneux
Pulmonary parasitic diseases are rare whereas pulmonary fungal infections are increasing. The diversity of clinical presentations requires laboratory tests to confirm the diagnosis. Direct examination of lung samples and antibody detection are the basis of parasitological diagnosis. With regard to mycoses, the range of biological tests is broader. The conventional mycological examination allows identification of any type of fungus except Pneumocystis jirovecii. Its specificity is excellent but it lacks sensitivity...
September 14, 2017: Revue des Maladies Respiratoires
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