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https://www.readbyqxmd.com/read/29792971/impact-of-active-surveillance-and-infection-control-measures-on-carbapenem-resistant-gram-negative-bacterial-colonization-and-infections-in-intensive-care
#1
T Karampatakis, K Tsergouli, E Iosifidis, C Antachopoulos, A Karapanagiotou, A Karyoti, N Gritsi-Gerogianni, A Tsakris, E Roilides
BACKGROUND: Carbapenem-resistant Gram-negative bacteria (CRGNB) infections constitute a global threat for critically ill patients and the outcome of their hospitalization. Early identification of CRGNB through rectal surveillance cultures and routine infection control measures including contact precautions, use of appropriate disinfectants, staff education on cleaning, and hand hygiene may reduce the dissemination of CRGNB. AIM: To assess the impact of enhanced infection control measures on CRGNB infections in a nine-bed polyvalent intensive care unit in a tertiary level hospital in an endemic area...
May 21, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29792779/association-of-colistin-resistant-kpc-clonal-strains-with-subsequent-infections-and-colonization-and-biofilm-production
#2
Melina Lorraine Ferreira, Bruna Fuga Araújo, Iara Rossi Gonçalves, Sabrina Royer, Paola Amaral Campos, Luiz Gustavo Machado, Deivid William Fonseca Batistão, Cristiane Silveira Brito, Paulo P Gontijo-Filho, Rosineide Marques Ribas
Carbapenemase-producing organisms are pandemic and a significant threat to public health. We investigated the clonal relatedness of colistin-resistant Klebsiella pneumoniae strains producing KPC-type carbapenemase (KPC-KP) causing subsequent infections or colonization. Moreover, we aimed to gain insight into the ability of biofilm production in K. pneumoniae strains producing carbapenemase. Twenty-two consecutive KPC-KP and one KPC-negative strain was identified from an adult intensive care unit in Brazil. Seventy-five percent of isolates that harbored the blaKPC gene exhibited genetic relatedness by pulsed-field gel electrophoresis, and none presented the plasmid-mediated mcr-1 and blaNDM genes...
May 24, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/29792721/-use-of-viscoelastic-methods-in-surgery
#3
D Šmíd, J Zatloukal, T Kural, J Fichtl, V Opatrný, J Moláček
INTRODUCTION: Major liver resections are associated with high morbidity and mortality. The main causes of this fact include a significant blood loss which may be associated with this surgical procedure. Hemocoagulation disorder, diagnosed by standard laboratory tests, is very frequent in the postoperative period and often requires the administration of blood derivatives. Several recent studies, however, have questioned the presence of such coagulopathy when viscoelastic methods are used to assess the coagulation process...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#4
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792375/knowledge-and-attitudes-of-family-doctors-dermatologists-and-endocrinologists-on-sun-exposure-and-vitamin-d
#5
Arif Abu-Abed, Said Azbarga, Roni Peleg
OBJECTIVES: Vitamin D is an important component of bone metabolism. Skin cells synthesize vitamin D when exposed to the sun. However, prolonged sun exposure damages the skin and increases the risk for skin cancer. The objective is to evaluate and compare the attitudes and recommendations of family doctors, dermatologists, and endocrinologists on exposure to the sun and vitamin D. METHODS: In a cross-sectional study, a questionnaire was completed by personal interview in a study population of 78 family doctors, 21 dermatologists, and 22 endocrinologists...
May 24, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29792242/testing-a-stepped-care-model-for-binge-eating-disorder-a-two-step-randomized-controlled-trial
#6
Giorgio A Tasca, Diana Koszycki, Agostino Brugnera, Livia Chyurlia, Nicole Hammond, Kylie Francis, Kerri Ritchie, Iryna Ivanova, Genevieve Proulx, Brian Wilson, Julie Beaulac, Hany Bissada, Erin Beasley, Nancy Mcquaid, Renee Grenon, Benjamin Fortin-Langelier, Angelo Compare, Louise Balfour
BACKGROUND: A stepped care approach involves patients first receiving low-intensity treatment followed by higher intensity treatment. This two-step randomized controlled trial investigated the efficacy of a sequential stepped care approach for the psychological treatment of binge-eating disorder (BED). METHODS: In the first step, all participants with BED (n = 135) received unguided self-help (USH) based on a cognitive-behavioral therapy model. In the second step, participants who remained in the trial were randomized either to 16 weeks of group psychodynamic-interpersonal psychotherapy (GPIP) (n = 39) or to a no-treatment control condition (n = 46)...
May 24, 2018: Psychological Medicine
https://www.readbyqxmd.com/read/29792239/screening-for-delirium-with-the-intensive-care-delirium-screening-checklist-icdsc-symptom-profile-and-utility-of-individual-items-in-the-identification-of-delirium-dependent-on-the-level-of-sedation
#7
Soenke Boettger, Rafael Meyer, André Richter, Susana Franco Fernandez, Alain Rudiger, Maria Schubert, Josef Jenewein, David Garcia Nuñez
OBJECTIVE: The importance of the proper identification of delirium, with its high incidence and adversities in the intensive care setting, has been widely recognized. One common screening instrument is the Intensive Care Delirium Screening Checklist (ICDSC); however, the symptom profile and key features of delirium dependent on the level of sedation have not yet been evaluated. METHOD: In this prospective cohort study, the ICDSC was evaluated versus the Diagnostic and Statistical Manual, 4th edition, text revision, diagnosis of delirium set as standard with respect to the symptom profile, and correct identification of delirium...
May 24, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29792232/effect-of-postoperative-goal-directed-therapy-in-cancer-patients-undergoing-high-risk-surgery-a-randomized-clinical-trial-and-meta-analysis
#8
Aline Rejane Muller Gerent, Juliano Pinheiro Almeida, Evgeny Fominskiy, Giovanni Landoni, Gisele Queiroz de Oliveira, Stephanie Itala Rizk, Julia Tizue Fukushima, Claudia Marques Simoes, Ulysses Ribeiro, Clarice Lee Park, Rosana Ely Nakamura, Rafael Alves Franco, Patricia Inês Cândido, Cintia Rosa Tavares, Ligia Camara, Graziela Dos Santos Rocha Ferreira, Elisangela Pinto Marinho de Almeida, Roberto Kalil Filho, Filomena Regina Barbosa Gomes Galas, Ludhmila Abrahão Hajjar
BACKGROUND: Perioperative goal-directed hemodynamic therapy (GDHT) has been advocated in high-risk patients undergoing noncardiac surgery to reduce postoperative morbidity and mortality. We hypothesized that using cardiac index (CI)-guided GDHT in the postoperative period for patients undergoing high-risk surgery for cancer treatment would reduce 30-day mortality and postoperative complications. METHODS: A randomized, parallel-group, superiority trial was performed in a tertiary oncology hospital...
May 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29792079/parent-perspectives-of-neonatal-tele-homecare-a-qualitative-study
#9
Kristina Garne Holm, Anne Brødsgaard, Gitte Zachariassen, Anthony C Smith, Jane Clemensen
Introduction Neonatal homecare for preterm infants is a method of supporting families and monitoring infant growth in the home setting. Telehealth may be used to deliver specialist neonatal care remotely, using online communication methods. This study explored parental experiences with neonatal tele-homecare (NTH). Methods Semi-structured interviews were conducted with 49 parents whose preterm infants had received NTH from a neonatal intensive care unit (NICU) in Denmark. Interview transcripts were analysed using Malterud's systematic text condensation...
January 1, 2018: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29791952/skin-punctures-in-preterm-infants-in-the-first-2-weeks-of-life
#10
Daragh Finn, Daryl Butler, Orla Sheehan, Vicki Livingstone, Eugene M Dempsey
OBJECTIVE:  The objective of this study was to investigate frequency and trends of skin punctures in preterm infants. STUDY DESIGN:  A prospective audit of preterm infants less than 35 weeks admitted over a 6-month period to a tertiary neonatal intensive care unit. Each skin puncture performed in the first 2 weeks of life was documented in a specifically designed audit sheet. RESULTS:  Ninety-nine preterm infants were enrolled. Infants born at < 32 weeks' gestation had significantly more skin punctures than infants > 32 weeks (median skin punctures 26...
May 23, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29791671/validation-of-a-moral-distress-instrument-in-nurses-of-primary-health-care
#11
Priscila Orlandi Barth, Flávia Regina Souza Ramos, Edison Luiz Devos Barlem, Graziele de Lima Dalmolin, Dulcinéia Ghizoni Schneider
OBJECTIVE: to validate an instrument to identify situations that trigger moral distress in relation to intensity and frequency in primary health care nurses. METHOD: this is a methodological study carried out with 391 nurses of primary health care, applied to the Brazilian Scale of Moral Distress in Nurses with 57 questions. Validation for primary health care was performed through expert committee evaluation, pre-test, factorial analysis, and Cronbach's alpha. RESULTS: there were 46 questions validated divided into six constructs: Health Policies, Working Conditions, Nurse Autonomy, Professional ethics, Disrespect to patient autonomy and Work Overload...
2018: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29791547/predictors-of-mortality-among-intensive-care-unit-patients-coinfected-with-tuberculosis-and-hiv
#12
Marcia Danielle Ferreira, Cynthia Pessoa das Neves, Alexandra Brito de Souza, Francisco Beraldi-Magalhães, Giovanni Battista Migliori, Afrânio Lineu Kritski, Marcelo Cordeiro-Santos
OBJECTIVE: To identify factors predictive of mortality in patients admitted to the ICU with tuberculosis (TB)/HIV coinfection in the Manaus, Amazon Region. METHODS: This was a retrospective cohort study of TB/HIV coinfected patients over 18 years of age who were admitted to an ICU in the city of Manaus, Brazil, between January of 2011 and December of 2014. Sociodemographic, clinical, and laboratory variables were assessed. To identify factors predictive of mortality, we employed a Cox proportional hazards model...
April 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29791362/real-time-super-resolved-3d-in-turbid-water-using-a-fast-range-gated-cmos-camera
#13
Petter Risholm, Jostein Thorstensen, Jens T Thielemann, Kristin Kaspersen, Jon Tschudi, Chris Yates, Chris Softley, Igor Abrosimov, Jonathan Alexander, Karl Henrik Haugholt
We present a range-gated camera system designed for real-time (10 Hz) 3D estimation underwater. The system uses a fast-shutter CMOS sensor (1280×1024) customized to facilitate gating with 1.67 ns (18.8 cm in water) delay steps relative to the triggering of a solid-state actively Q-switched 532 nm laser. A depth estimation algorithm has been carefully designed to handle the effects of light scattering in water, i.e., forward and backward scattering. The raw range-gated signal is carefully filtered to reduce noise while preserving the signal even in the presence of unwanted backscatter...
May 10, 2018: Applied Optics
https://www.readbyqxmd.com/read/29791307/symptomatic-pneumocephalus-a-rare-complication-of-discal-herniation-s-surgery
#14
Ghassen Gader, Nadhir Karmeni, Imed Ben Saïd, Hafedh Jemel
Context We report the case of a 40-year-old woman with no pathological history, operated from an L4-L5 disc herniation by a left unilateral approach. The dura mater enveloping the left L5 root was accidentally injured at its lateral face causing a breach with CSF leakage. This breach could not be sutured. A few hours after waking, the patient presented an agitation followed by three generalized tonico-clonic seizures. Cerebral imaging revealed pneumocephalus. The patient was hospitalized in an intensive care unit...
May 23, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29791253/nurse-led-communication-in-the-intensive-care-unit
#15
Daniela Lamas
No abstract text is available yet for this article.
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#16
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791238/low-dose-ketamine-infusion-for-adjunct-management-during-vaso-occlusive-episodes-in-adults-with-sickle-cell-disease-a-case-series
#17
Nicole Palm, Catherine Floroff, Tanna B Hassig, Alice Boylan, Julie Kanter
The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs)...
May 23, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29790870/genetic-disorders-and-mortality-in-infancy-and-early-childhood-delayed-diagnoses-and-missed-opportunities
#18
Monica H Wojcik, Talia S Schwartz, Inbar Yamin, Heather L Edward, Casie A Genetti, Meghan C Towne, Pankaj B Agrawal
PurposeInfants admitted to a level IV neonatal intensive care unit (NICU) who do not survive early childhood are a population that is probably enriched for rare genetic disease; we therefore characterized their genetic diagnostic evaluation.MethodsThis is a retrospective analysis of infants admitted to our NICU between 1 January 2011 and 31 December 2015 who were deceased at the time of records review, with age at death less than 5 years.ResultsA total of 2,670 infants were admitted; 170 later died. One hundred six of 170 (62%) had an evaluation for a genetic or metabolic disorder...
April 12, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29790849/-n-methyl-d-aspartate-receptor-antibody-encephalitis-the-janus-faced-disorder
#19
Ildiko Sipos
The recognition of the antibody-mediated encephalitis as a separate entity among the immune disorders of the central nervous system was one of the greatest breakthroughs of the last two decades in neurology. Unlike viral or tumor-related encephalitis, the antibody-mediated form has a good response to immunotherapy, which gives a special clinical importance to the discovery. Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is one of the first fully characterized antibody-mediated encephalitises. This article attempts to summarize the clinical features of this complex neuropsychiatric disorder with the aim to help its early recognition and to report the clinical course and the outcome of our six seropositive anti-NMDAR cases...
March 2018: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/29790445/a-study-of-deficiencies-in-teamwork-skills-among-jordan-caregivers
#20
Omar Al-Araidah, Nader Al Theeb, Mariam Bader, Nabeel Mandahawi
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members...
May 14, 2018: International Journal of Health Care Quality Assurance
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