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https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#1
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29730141/characteristics-of-antimicrobial-stewardship-programmes-in-rural-east-texas-hospitals
#2
Jonathan C Cho, Rebecca L Dunn, Frank Yu, Grace A Loredo, Bradley Brazill
INTRODUCTION: Antimicrobial stewardship programs (ASPs) serve as the primary method to prevent and manage the development of antimicrobial resistance. Rural settings may lack the recommended personnel and resources needed to provide antimicrobial stewardship services. METHODS: An electronic survey was distributed via e-mail to pharmacy directors or antimicrobial stewardship programme directors of licensed hospitals within the Public Health Region 4/5N of East Texas...
May 3, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29710650/characterizing-variable-biogeochemical-changes-during-the-treatment-of-produced-oilfield-waste
#3
Zacariah L Hildenbrand, Inês C Santos, Tiffany Liden, Doug D Carlton, Emmanuel Varona-Torres, Misty S Martin, Michelle L Reyes, Safwan R Mulla, Kevin A Schug
At the forefront of the discussions about climate change and energy independence has been the process of hydraulic fracturing, which utilizes large amounts of water, proppants, and chemical additives to stimulate sequestered hydrocarbons from impermeable subsurface strata. This process also produces large amounts of heterogeneous flowback and formation waters, the subsurface disposal of which has most recently been linked to the induction of anthropogenic earthquakes. As such, the management of these waste streams has provided a newfound impetus to explore recycling alternatives to reduce the reliance on subsurface disposal and fresh water resources...
April 16, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29696325/colonization-with-multidrug-resistant-enterobacteriaceae-is-associated-with-increased-mortality-following-burn-injury-in-sub-saharan-africa
#4
Jared R Gallaher, Wone Banda, Anne M Lachiewicz, Robert Krysiak, Bruce A Cairns, Anthony G Charles
BACKGROUND: Multidrug-resistant (MDR) bacteria are an emerging international concern in low- and middle-income countries that threaten recent public health gains. These challenges are exacerbated in immunocompromised hosts, such as those with burn injury. This study sought to describe the epidemiology and associated clinical outcomes of burn wound colonization in a Malawian tertiary burn center. METHODS: This is a prospective analysis of burn patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi, within 72 h of burn injury...
April 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29668905/antimicrobial-stewardship-training-for-infectious-diseases-fellows-program-directors-identify-a-curriculum-need
#5
Vera P Luther, Rachel Shnekendorf, Lilian M Abbo, Sonali Advani, Wendy S Armstrong, Alice E Barsoumian, Cole B Beeler, Rachel Bystritsky, Kartikeya Cherabuddi, Seth Cohen, Keith W Hamilton, Dilek Ince, Julie Ann Justo, Ashleigh Logan, John B Lynch, Priya Nori, Christopher A Ohl, Payal K Patel, Paul S Pottinger, Brian S Schwartz, Conor Stack, Yuan Zhou
A needs assessment survey of Infectious Diseases (ID) training program directors identified gaps concerning comprehensive and structured educational resources for training and evaluating ID fellows in antimicrobial stewardship. An IDSA-sponsored antimicrobial stewardship core curriculum was subsequently developed to address that need.
April 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29649602/point-of-care-and-point-of-can-leveraging-reference-laboratory-capacity-for-integrated-diagnosis-of-fever-syndromes-in-the-tropics
#6
REVIEW
Makeda Semret, Momar Ndao, Jan Jacobs, Cedric P Yansouni
BACKGROUND: There is an urgent need for integrated diagnosis of febrile syndromes, able to account for multiple pathogens and inform decisions for clinical care and public health. AIMS: To reflect on the evolving roles of laboratory-based testing for non-malarial febrile illnesses (NMFI) in low-resource settings (LRS), and to consider how advances in diagnostics, in connectivity and transport, and in quality-systems implementation may substantially enhance the capacity of reference laboratories to bridge the current gap between remote passive surveillance and clinically meaningful integrated fever diagnosis...
April 9, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29629051/the-challenges-of-strategic-purchasing-of-healthcare-services-in-iran-health-insurance-organization-a-qualitative-study
#7
Hasan Abolghasem Gorji, Sayyed Masoud Shajari Pour Mousavi, Ali Shojaei, Anahita Keshavarzi, Hossein Zare
Background: Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. Objective: To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO)...
February 2018: Electronic Physician
https://www.readbyqxmd.com/read/29625170/developing-core-elements-and-checklist-items-for-global-hospital-antimicrobial-stewardship-programmes-a-consensus-approach
#8
Céline Pulcini, Francesca Binda, Anjana Sankhil Lamkang, Anna Trett, Esmita Charani, Debra A Goff, Stephan Harbarth, Sylvia Lemos Hinrichsen, Gabriel Levy-Hara, Marc Mendelson, Dilip Nathwani, Revathi Gunturu, Sanjeev Singh, Arjun Srinivasan, Visanu Thamlikitkul, Karin Thursky, Erika Vlieghe, Heiman Wertheim, Mei Zeng, Sumanth Gandra, Ramanan Laxminarayan
OBJECTIVES: With increasing interest in hospital antimicrobial stewardship (AMS) programmes globally, there is a strong demand for core elements of AMS to be clearly defined based on principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals, regardless of resource availability, worldwide...
April 2, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29621001/antibiotic-use-and-antimicrobial-resistance-of-surgical-patients-with-peritonitis-at-a-tertiary-referral-hospital-in-rwanda
#9
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere, Rahel G Ghebre
BACKGROUND: There is growing recognition of the worsening problem of antibiotic resistance and the need for antibiotic stewardship in low-resource settings. The aim of this study was to describe antibiotic use and antimicrobial resistance in patients undergoing surgery for peritonitis at a Rwandan referral hospital. PATIENTS AND METHODS: All surgical patients with peritonitis at a Rwandan referral hospital were enrolled. Prospective data were collected on epidemiology, clinical features, interventions, and outcomes...
April 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29597059/chemical-application-strategies-to-protect-water-quality
#10
Pamela J Rice, Brian P Horgan, Brian L Barber, William C Koskinen
Management of turfgrass on golf courses and athletic fields often involves application of plant protection products to maintain or enhance turfgrass health and performance. However, the transport of fertilizer and pesticides with runoff to adjacent surface waters can enhance algal blooms, promote eutrophication and may have negative impacts on sensitive aquatic organisms and ecosystems. Thus, we evaluated the effectiveness of chemical application setbacks to reduce the off-site transport of chemicals with storm runoff...
March 26, 2018: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/29590355/essential-resources-and-strategies-for-antibiotic-stewardship-programs-in-the-acute-care-setting
#11
Sarah B Doernberg, Lilian M Abbo, Steven D Burdette, Neil O Fishman, Edward L Goodman, Gary R Kravitz, James E Leggett, Rebekah W Moehring, Jason G Newland, Philip A Robinson, Emily S Spivak, Pranita D Tamma, Henry F Chambers
Background: Antibiotic stewardship programs improve clinical outcomes and patient safety and help combat antibiotic resistance. Specific guidance on resources needed to structure stewardship programs is lacking. This manuscript describes results of a survey of U.S. stewardship programs and resultant recommendations regarding potential staffing structures in the acute care setting. Methods: A cross-sectional survey of members of three infectious diseases subspecialty societies actively involved in antibiotic stewardship was conducted...
March 26, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29575106/antifungal-treatment-in-haematological-and-oncological-patients-need-for-quality-assessment-in-routine-care
#12
S J Lachenmayr, S Berking, H Horns, D Strobach, H Ostermann, K Berger
Invasive fungal infections in haematological and oncological patients have a major impact on morbidity, mortality and treatment costs. Therefore, rational use of antifungal agents is important for optimal patient care and resource use. Objective was to analyze antifungal usage in a German tertiary teaching hospital department of haematology and oncology, to evaluate quality of antifungal treatment and to assess the need for an antifungal stewardship programme. This retrospective observational study included patients≥ 18 years receiving systemic antifungals for prophylaxis or therapy of invasive fungal infection between 01-06/2016...
March 25, 2018: Mycoses
https://www.readbyqxmd.com/read/29573053/barriers-to-and-enablers-of-implementing-antimicrobial-stewardship-programs-in-veterinary-practices
#13
Laura Y Hardefeldt, J R Gilkerson, H Billman-Jacobe, M A Stevenson, K Thursky, K E Bailey, G F Browning
BACKGROUND: Antimicrobial stewardship (AMS) programs are yet to be widely implemented in veterinary practice and medical programs are unlikely to be directly applicable to veterinary settings. OBJECTIVE: To gain an in-depth understanding of the factors that influence effective AMS in veterinary practices in Australia. METHODS: A concurrent explanatory mixed methods design was used. The quantitative phase of the study consisted of an online questionnaire to assess veterinarians' attitudes to antimicrobial resistance (AMR) and antimicrobial use in animals, and the extent to which AMS currently is implemented (knowingly or unknowingly)...
March 23, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29549061/impact-of-quickfish-in-addition-to-antimicrobial-stewardship-on-vancomycin-use-and-resource-utilization-in-cancer-patients-with-coagulase-negative-staphylococcal-blood-cultures
#14
S K Seo, Z Gedrimaite, A Paskovaty, K Seier, S Morjaria, N Cohen, E Riedel, Y W Tang, N E Babady
OBJECTIVE: To evaluate the impact of rapidly identifying coagulase-negative staphylococci (CoNS) from positive blood cultures combined with an established antimicrobial stewardship (AS) programme at a tertiary cancer centre. METHODS: We compared cancer patients ≥18 years old who between 01/1/13 and 12/31/13 had one or more positive CoNS blood culture(s) identified by Staphylococcus QuickFISH® (a peptide nucleic acid fluorescence in situ hybridization assay) with cancer patients ≥18 years old who had CoNS identified by standard microbiological techniques between 01/01/11 and 12/31/11 (baseline)...
March 13, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29532567/variations-in-practice-patterns-and-resource-utilization-in-patients-treated-for-chronic-obstructive-pulmonary-disease
#15
Sunil H Adwani, Cai Yuan, Leen Alsaleh, Julie Pepe, Khalid Abusaada
RATIONALE, AIMS, AND OBJECTIVES: Several studies have looked at patient-related variables influencing hospital length of stay (LOS) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, there has been increasing recognition that physician-related factors also play a significant role. This study aims to evaluate differences in practice patterns between teaching and nonteaching services and their effect on LOS in a large community hospital. METHODS: A retrospective study of 354 patients admitted to Florida Hospital, Orlando, with AECOPD between January 2009 and December 2011...
March 13, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29531395/potential-negative-effects-of-antimicrobial-allergy-labelling-on-patient-care-a-systematic-review
#16
REVIEW
Julie Hui-Chih Wu, Bradley J Langford, Kevin L Schwartz, Rosemary Zvonar, Sumit Raybardhan, Valerie Leung, Gary Garber
Background: Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. Objective: To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. Data Sources: The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016...
January 2018: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29514268/effects-of-primary-care-antimicrobial-stewardship-outreach-on-antibiotic-use-by-general-practice-staff-pragmatic-randomized-controlled-trial-of-the-target-antibiotics-workshop
#17
Cliodna McNulty, Meredith Hawking, Donna Lecky, Leah Jones, Rebecca Owens, André Charlett, Chris Butler, Philippa Moore, Nick Francis
Objectives: To determine whether local trainer-led TARGET antibiotic interactive workshops improve antibiotic dispensing in general practice. Methods: Using a McNulty-Zelen-design randomized controlled trial within three regions of England, 152 general practices were stratified by clinical commissioning group, antibiotic dispensing rate and practice patient list size, then randomly allocated to intervention (offered TARGET workshop that incorporated a presentation, reflection on antibiotic data, promotion of patient and general practice (GP) staff resources, clinical scenarios and action planning, 73 practices) or control (usual practice, 79 practices)...
March 5, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29506043/a-national-quality-incentive-scheme-to-reduce-antibiotic-overuse-in-hospitals-evaluation-of-perceptions-and-impact
#18
J Islam, D Ashiru-Oredope, E Budd, P Howard, A S Walker, S Hopkins, M J Llewelyn
Background: In 2016/2017, a financially linked antibiotic prescribing quality improvement initiative Commissioning for Quality and Innovation (AMR-CQUIN) was introduced across acute hospitals in England. This aimed for >1% reductions in DDDs/1000 admissions of total antibiotics, piperacillin/tazobactam and carbapenems compared with 2013/2014 and improved review of empirical antibiotic prescriptions. Objectives: To assess perceptions of staff leading antimicrobial stewardship activity regarding the AMR-CQUIN, the investments made by hospitals to achieve it and how these related to achieving reductions in antibiotic use...
February 28, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29497501/implementing-health-care-reform-implications-for-performance-of-public-hospitals-in-central-ethiopia
#19
Tsegahun Manyazewal, Mokgadi C Matlakala
Background: Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. Methods: A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia...
June 2018: Journal of Global Health
https://www.readbyqxmd.com/read/29493640/-the-interplay-of-diagnostic-and-antimicrobial-stewardship-for-the-management-of-septic-patients-the-tuscan-model
#20
Silvia Forni, Giulio Toccafondi, Bruno Viaggi, Maddalena Grazzini, Sara D'Arienzo, Fabrizio Gemmi, Andrea Vannucci, Giorgio Tulli
Antimicrobial resistance is a global threat caused by the rapid spread of multiresistant microorganisms. Antimicrobial stewardship (AS) is a coordinated intervention designed to improve the appropriate use of antimicrobials by promoting the selection of the optimal drug regimen, dose, duration of therapy and route of administration. AS programs have proved effective in reducing antimicrobial resistance, inappropriate antimicrobial use and in improving patient outcomes. Recently developed rapid diagnostic technologies in microbiology (RDTM) allows a faster and etiological diagnosis of infection and a reduction in the use of unnecessary empirical therapies...
February 2018: Recenti Progressi in Medicina
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