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https://www.readbyqxmd.com/read/29792133/impact-of-collaborative-shared-medical-appointments-on-diabetes-outcomes-in-a-family-medicine-clinic
#1
Melody L Hartzler, McKenzie Shenk, Julie Williams, James Schoen, Thomas Dunn, Douglas Anderson
Purpose The purpose of this study is to evaluate the impact of a collaborative diabetes shared medical appointment on patient outcomes in an urban family medicine practice. Methods Fifty-nine patients were enrolled to participate in multiple shared medical appointments (SMAs) over 12 months. Baseline data included hemoglobin (A1C), lipids, systolic blood pressure (SBP), weight, adherence to American Diabetes Association (ADA) guidelines, and surveys, including the Problem Areas in Diabetes (PAID-2) scale and the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD)...
May 1, 2018: Diabetes Educator
https://www.readbyqxmd.com/read/29785504/impact-of-a-vap-bundle-in-belgian-intensive-care-units
#2
Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux, Pierre Damas
BACKGROUND: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. METHODS: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients...
May 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#3
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#4
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29778036/polymeric-nanoparticles-as-a-platform-for-permeability-enhancement-of-class-iii-drug-amikacin
#5
Saman Fatima, Zeenat Iqbal, A K Panda, M Samim, Sushama Talegaonkar, Farhan Jalees Ahmad
Amikacin (A), a water soluble aminoglycoside antibiotic is commercially available for intravenous administration only. Present investigation is aimed at the development of poly-lactic-co-glycolic acid (PLGA) nanoparticles (A-NPs).1 for oral permeability enhancement of amikacin. The pharmaceutical attributes of the A-NPs revealed particle size, 260.3 ± 2.05 nm, zeta potential, -12.9 ± 1.12 mV and drug content, 40.10 ± 1.87 μg/mg with spherical shape and smooth surface. In vitro antibacterial studies showed that the A-NPs were active against P...
May 16, 2018: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/29740931/antimicrobial-prescription-in-patients-dying-from-chronic-obstructive-pulmonary-disease
#6
John Taverner, Lauren Ross, Claire Bartlett, M Luthe, J Ong, Louis Irving, Natasha Smallwood
INTRODUCTION: Despite rising antimicrobial resistance, treatment guidelines for COPD exacerbations are frequently ignored. Patients with terminal conditions are often prescribed antimicrobials despite the goal of care to reduce burdensome treatments. The appropriateness of antimicrobials in patients dying from an exacerbation of COPD is unknown. AIM: To review antimicrobial prescription at the time of death in patients who died from COPD. METHODS: A retrospective medical record audit was performed for 475 patients who died over twelve years (2004-2015)...
May 9, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29735823/antimicrobial-susceptibility-profiles-of-gram-negative-bacteria-causing-infections-collected-across-india-during-2014-2016-study-for-monitoring-antimicrobial-resistance-trend-report
#7
Balaji Veeraraghavan, Mark Ranjan Jesudason, John Antony Jude Prakasah, Shalini Anandan, Rani Diana Sahni, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Rajesh Joseph Selvakumar, T N Dhole, Camilla Rodrigues, Indranil Roy, Sangeetha Joshi, Bhaskar Narayan Chaudhuri, D S Chitnis
Background: The emergence of antibiotic resistance among bacterial pathogens in the hospital and community has increased the concern to the health-care providers due to the limited treatment options. Surveillance of antimicrobial resistance (AMR) in frequently isolated bacterial pathogens causing severe infections is of great importance. The data generated will be useful for the clinicians to decide empiric therapy on the local epidemiological resistance profile of the antimicrobial agents...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29733782/idiopathic-pulmonary-fibrosis-what-primary-care-physicians-need-to-know
#8
REVIEW
Leslie B Tolle, Brian D Southern, Daniel A Culver, Jeffrey C Horowitz
Idiopathic pulmonary fibrosis (IPF) is a specific type of fibrosing interstitial pneumonia of unknown cause. It is usually chronic and progressive, tends to affect mainly adults over age 60, has a predilection for men, and is often fatal. The condition is still underappreciated by pulmonologists and primary care physicians. This article attempts to close that information gap by reviewing the natural course of IPF and presenting an algorithmic approach to diagnosis and treatment based on evidence-based international guidelines...
May 2018: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29731643/ugly-bugs-in-healthy-guts-carriage-of-multidrug-resistant-and-esbl-producing-commensal-enterobacteriaceae-in-the-intestine-of-healthy-nepalese-adults
#9
Anjila Maharjan, Anjeela Bhetwal, Shreena Shakya, Deepa Satyal, Shashikala Shah, Govardhan Joshi, Puspa Raj Khanal, Narayan Prasad Parajuli
Background: Fecal carriage of multidrug-resistant and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is one of the important risk factors for infection with antibiotic-resistant bacteria. In this report, we examined the prevalence of multidrug-resistant and ESBL-producing common enterobacterial strains colonizing the intestinal tract of apparently healthy adults in Kathmandu, Nepal. Methods: During a 6-month period (February-July 2016), a total of 510 stool specimens were obtained from apparently healthy students of Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29728084/group-b-streptococci-vaginal-colonization-and-drug-susceptibility-pattern-among-pregnant-women-attending-in-selected-public-antenatal-care-centers-in-addis-ababa-ethiopia
#10
Solomon Assefa, Kassu Desta, Tsehaynesh Lema
BACKGROUND: Group B Streptococcus (GBS) is the leading cause of septicemia, meningitis, and pneumonia in neonates. Maternal colonization with GBS is the principal risk factor for early-onset disease in infants. Group B Streptococcus is now an important cause of maternal and neonatal morbidity and mortality in many parts of the world. In Ethiopia, few studies have been done on GBS colonization among pregnant women. The aim of this study was to determine the prevalence of GBS colonization, antimicrobial susceptibility patterns and assess risk factors among pregnant women...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29724618/missed-opportunities-in-the-diagnosis-of-human-immunodeficiency-virus-infection-in-the-region-of-aragon-late-diagnosis-importance
#11
César Gargallo-Bernad, Francisco Javier Sangrós-González, Piedad Arazo-Garcés, Rosa Martínez-Álvarez, Carmen Malo-Aznar, Alicia Gargallo-Bernad, Alba Ballester-Luna, Luis Eduardo Cabrero-Pascual, Pablo Gil-Orna, Víctor José Abadía-Gallego, Isabel Torres-Peña, Héctor Ordiz-Suárez
INTRODUCTION: Late Diagnosis (LD) of Human Immunodeficiency Virus (HIV) infection (CD4 lymphocytes <350/μl at diagnosis of the disease), deteriorates the condition of those affected and increases the probability of transmission. The objective of the present study was to analyse the prevalence of LD, to identify missed diagnostic opportunities (MDO) and to find out which level of the health care delivery system they took place. METHODS: Retrospective, observational and descriptive study of the population diagnosed with infection of HIV/AIDS in the period 2011-2015 in Aragon...
April 30, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29722052/the-methodological-quality-of-guidelines-for-hospital-acquired-pneumonia-and-ventilator-associated-pneumonia-a-systematic-review
#12
REVIEW
R Ambaras Khan, Z Aziz
WHAT IS KNOWN AND OBJECTIVES: Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29718746/japan-college-of-rheumatology-guideline-for-the-use-of-methotrexate-in-patients-with-rheumatoid-arthritis
#13
Hideto Kameda, Takao Fujii, Ayako Nakajima, Ryuji Koike, Akira Sagawa, Katsuaki Kanbe, Tetsuya Tomita, Masayoshi Harigai, Yasuo Suzuki
Methotrexate (MTX), the anchor drug in the current treatment strategy for rheumatoid arthritis (RA), was first approved for treatment of RA in Japan in 1999 at the recommended dose of 6-8 mg/week; it was approved as first-line drug with the maximum dose of 16 mg/week in February 2011. However, more than half of Japanese patients with RA are unable to tolerate a dose of 16 mg/week of MTX. Moreover, some serious adverse events during the treatment with MTX, such as pneumocystis pneumonia and lymphoproliferative disorders, have been observed much more frequently in Japan than in other countries...
May 2, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29717284/antibiotic-susceptibility-pattern-of-gram-negative-isolates-of-lower-respiratory-tract-infection
#14
Rakshya Nepal, Basudha Shrestha, Deepak Man Joshi, Rajesh Dhoj Joshi, Sanjit Shrestha, Anjana Singh
BACKGROUND: Lower respiratory tract infection is a common cause of morbidity and mortality worldwide. A cross-sectional study was carried out with an objective to study the antibiogram of Gram-negative isolates of patients with lower respiratory tract infection visiting Kathmandu Model Hospital. METHODS: A total of 274 specimens including sputum, endotracheal aspirates, suction tips were cultured as per standard microbiological technique. Antibiotic susceptibility and detection of Extended-spectrum beta- lactamases (ESBLs) were performed following Clinical Laboratory Standard Institute (CLSI 2014) guidelines...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29703037/fatal-malignant-pertussis-with-hyperleukocytosis-in-a-chinese-infant-a-case-report-and-literature-review
#15
Shu-Feng Tian, Hong-Mei Wang, Ji-Kui Deng
RATIONALE: Pertussis has re-emerged on a global scale and is an ongoing public health problem, even in countries with high rates of vaccination. Hyperleukocytosis [white blood cell (WBC) count >100 × 10/L] is a rare complication that strongly predicts mortality in cases of severe pertussis. PATIENT CONCERNS: We report a case of severe pertussis in an infant who initially presented with persistent cyanotic cough, tachypnea, and grunting. The infant's condition deteriorated rapidly, and she was transferred to the pediatric intensive care unit (PICU) during her third hour of hospitalization...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29699493/effects-of-age-comorbidity-and-adherence-to-current-antimicrobial-guidelines-on-mortality-in-hospitalized-elderly-patients-with-community-acquired-pneumonia
#16
Xiudi Han, Fei Zhou, Hui Li, Xiqian Xing, Liang Chen, Yimin Wang, Chunxiao Zhang, Xuedong Liu, Lijun Suo, Jinxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Jay E Purdy, Bin Cao
BACKGROUND: Limited information exists on the clinical characteristics predictive of mortality in patients aged ≥65 years in many countries. The impact of adherence to current antimicrobial guidelines on the mortality of hospitalized elderly patients with community-acquired pneumonia (CAP) has never been assessed. METHODS: A total of 3131 patients aged ≥65 years were enrolled from a multi-center, retrospective, observational study initiated by the CAP-China network...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29693574/liver-transplantation-and-gut-microbiota-profiling-in-a-child-colonized-by-a-multi-drug-resistant-klebsiella-pneumoniae-a-new-approach-to-move-from-antibiotic-to-eubiotic-control-of-microbial-resistance
#17
Federica Del Chierico, Sabrina Cardile, Andrea Pietrobattista, Daniela Liccardo, Alessandra Russo, Manila Candusso, Maria Sole Basso, Chiara Grimaldi, Laura Pansani, Paola Bernaschi, Giuliano Torre, Lorenza Putignani
The increase of microorganisms multi-drug resistant (MDR) to antibiotics (ATBs) is becoming a global emergency, especially in frail subjects. In chronic liver disease (LD) with indications for liver transplantation (LT), MDR colonization can significantly affect the LT outcome. However, no clear guidelines for microbial management are available. A novel approach toward MDR-colonized patients undergoing LT was developed at our Center refraining from ATBs use during the transplant waiting list, and use of an intensive perioperative prophylaxis cycle...
April 25, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29692574/phenotypic-and-genotypic-characterization-of-carbapenem-resistance-mechanisms-in-klebsiella-pneumoniae-from-blood-culture-specimens-a-study-from-north-india
#18
Varsha Gupta, Ritu Garg, Karthikeyan Kumaraswamy, Priya Datta, Gursimran Kaur Mohi, Jagdish Chander
BACKGROUND: Emergence of carbapenem resistance among Enterobacteriaceae in different geographical regions is of great concern as these bacteria are easily transmissible among patients. Carbapenem-resistance in Enterobacteriaceae is due to production of carbapenemases of various classes and hyper production of the ESBLs (Extended spectrum beta lactamases) and Amp C beta lactamases with reduced cell wall permeability mechanisms. Phenotypic detection and differentiation is important for proper infection control and appropriate patient management...
April 2018: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/29690685/-current-status-of-diagnosis-and-treatment-of-community-acquired-pneumonia-in-shanghai-revealed-by-a-questionnaire-analysis
#19
J Liu, J Zhang, Q J Cheng, J F Xu, Z J Jie, Y Jiao, Y Huang, J M Qu
Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29690680/-update-and-understanding-2018-chinese-guidelines-for-the-dignosis-and-treatment-of-adults-eith-hospital-acquired-and-ventilator-associated-pneumonia
#20
J M Qu, Y Shi
No abstract text is available yet for this article.
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
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