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https://www.readbyqxmd.com/read/28636060/developing-mobile-clinical-decision-support-for-nursing-home-staff-assessment-of-urinary-tract-infection-using-goal-directed-design
#1
Wallace Jones, Cynthia Drake, David Mack, Blaine Reeder, Barbara Trautner, Heidi Wald
BACKGROUND: Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. OBJECTIVES: We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff...
June 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#2
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28634098/sepsis-within-30-days-of-geriatric-hip-fracture-surgery
#3
Daniel D Bohl, Stephanie E Iantorno, Bryan M Saltzman, Matthew W Tetreault, Brian Darrith, Craig J Della Valle
BACKGROUND: Sepsis after hip fracture typically develops from one of the 3 potential infectious sources: urinary tract infection (UTI), pneumonia, and surgical site infection (SSI). The purpose of this investigation is to determine (1) the proportion of cases of sepsis that arises from each of these potential infectious sources; (2) baseline risk factors for developing each of the potential infectious sources; and (3) baseline risk factors for developing sepsis. METHODS: The National Surgical Quality Improvement Program database was searched for geriatric patients (aged >65 years) who underwent surgery for hip fracture during 2005-2013...
May 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633453/a-multifaceted-quality-improvement-strategy-reduces-the-risk-of-catheter-associated-urinary-tract-infection
#4
Cecelia N Theobald, Matthew J Resnick, Thomas Spain, Robert S Dittus, Christianne L Roumie
Objective: Catheter-associated urinary tract infections (CAUTIs) are common and preventable hospital-acquired infections, yet their rate continues to rise nationwide. We describe the implementation of a multifaceted program to reduce catheter use and CAUTI rates while simultaneously addressing barriers to long-term success. Design/Setting/Participants: Pre-post study of medical inpatient veterans between December 2012 and February 2015. Intervention: Five component intervention: (i) a bedside catheter reminder; (ii) multidisciplinary educational campaign; (iii) structured catheter order set with clinical decision support; (iv) automated catheter discontinuation orders; and (v) protocol for post-catheter removal care...
June 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28632946/emerging-biomarkers-of-illness-severity-urinary-metabolites-associated-with-sepsis-and-necrotizing-methicillin-resistant-staphylococcus-aureus-pneumonia
#5
Lilliam Ambroggio, Todd A Florin, Samir S Shah, Richard Ruddy, Larisa Yeomans, Julie Trexel, Kathleen A Stringer
STUDY OBJECTIVE: To illustrate the potential of metabolomics to identify novel biomarkers of illness severity in a child with fatal necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Case report with two control groups and a metabolomics analysis. PATIENTS: An infant with fatal MRSA pneumonia, four children with influenza pneumonia (pneumonia control group), and seven healthy children with no known infections (healthy control group)...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28632834/-bladder-fungus-ball-by-candida-tropicalis-a-pediatric-case-report
#6
Ecil Santos, Mónica Mercado, Antonio Luévanos, Pedro Martínez, Martín Guerrero
Vesical fungus ball is a mobile, oval and echogenic mass as a result of accumulation of long and wide numerous hyphae. Fungal urinary tract infection incidence has increased notoriously and there are isolated yeast in 7 to 8% of urine cultures. Different species of Candida are cause of urinary tract infection. Epidemiologically, the first isolated pathogen is Candida albicans, followed by Candida tropicalis. Bladder poll has been documented as the most important risk factor for candiduria in critical patients into intensive care...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632827/-occult-bacteremia-in-s%C3%A3-tero-del-r%C3%A3-o-hospital-experience-after-pneumococcal-conjugated-vaccine
#7
Isolda Budnik, Alejandra Sandoval, Alejandra Prado, Marcela Labbé, Anamaría Peña, Tamara Viviani
BACKGROUND: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room. OBJECTIVE: describe OB in the era after introduction of pneumococcal vaccine in Chile. PATIENTS AND METHODS: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013. RESULTS: Possible OB was diagnosed on 391 patients...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632788/high-throughput-identification-and-rational-design-of-synergistic-small-molecule-pairs-for-combating-and-bypassing-antibiotic-resistance
#8
Morgan A Wambaugh, Viplendra P S Shakya, Adam J Lewis, Matthew A Mulvey, Jessica C S Brown
Antibiotic-resistant infections kill approximately 23,000 people and cost $20,000,000,000 each year in the United States alone despite the widespread use of small-molecule antimicrobial combination therapy. Antibiotic combinations typically have an additive effect: the efficacy of the combination matches the sum of the efficacies of each antibiotic when used alone. Small molecules can also act synergistically when the efficacy of the combination is greater than the additive efficacy. However, synergistic combinations are rare and have been historically difficult to identify...
June 2017: PLoS Biology
https://www.readbyqxmd.com/read/28631906/-technical-features-of-intestinal-ureteroplasty-part-7-forming-ureterointestinal-anastomoses
#9
B K Komyakov, V A Ochelenko, M V Onoshko, T Kh Al-Attar, A Kh Gaziev
AIM: To present the results and technical features of forming the ureterointestinal anastomoses in intestinal ureteral substitution. MATERIAL AND METHODS: From 1998 to December 2016, 168 patients (mean age 51 +/- 8.7 years) underwent ureteral substitution using intestinal segments at the Urology Clinic of the I.I. Mechnikov NWSMU. Of them, 76 (45.2%) were males. In 119 (70.8%) patients, intestinal segments were used to replace various parts of the ureters (iliac in 92, colonic in 4, appendix in 23), and in 49 (29...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28631830/overactive-bladder-symptoms-after-midurethral-sling-surgery-in-women-risk-factors-and-management
#10
Tom Marcelissen, Philip Van Kerrebroeck
INTRODUCTION: Overactive bladder syndrome (OAB) including urgency and urgency urinary incontinence (UUI) occurs frequently after stress urinary incontinence (SUI) surgery. It is important to identify the risk factors for the occurrence of OAB symptoms in order to adequately inform the patient before surgery. Furthermore, when facing OAB after sling surgery it is crucial to know how to manage these symptoms. METHODS: We conducted a literature review in order to assess the risk factors and management of OAB symptoms after SUI surgery...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28631577/the-impact-of-opioid-medications-on-subsequent-fractures-in-discharged-emergency-department-patients-with-peripheral-vertigo
#11
Keerat Grewal, Peter C Austin, Moira K Kapral, Hong Lu, Clare L Atzema
BACKGROUND: Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids. OBJECTIVES: To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period...
June 20, 2017: CJEM
https://www.readbyqxmd.com/read/28631216/safety-and-tolerability-of-empagliflozin-in-patients-with-type-2-diabetes-pooled-analysis-of-phase-i-iii-clinical-trials
#12
Sven Kohler, Cordula Zeller, Hristo Iliev, Stefan Kaspers
INTRODUCTION: We characterized the safety and tolerability of empagliflozin in patients with type 2 diabetes (T2DM) randomized 1:1:1 to placebo, empagliflozin 10 mg, or empagliflozin 25 mg in clinical trials. METHODS: Pooled data were analyzed from patients with T2DM treated with placebo (N = 4203), empagliflozin 10 mg (N = 4221), or empagliflozin 25 mg (N = 4196) in 15 randomized phase I-III trials plus four extension studies. Adverse events (AEs) were assessed descriptively in participants who took at least one dose of study drug...
June 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28630628/staphylococcus-saprophyticus-recovered-from-humans-food-and-recreational-waters-in-rio-de-janeiro-brazil
#13
Viviane Santos de Sousa, Ana Paula de Souza da-Silva, Leif Sorenson, Raphael Paiva Paschoal, Renata Fernandes Rabello, Eloiza Helena Campana, Márcia Soares Pinheiro, Lyssa Oliveira Ferreira Dos Santos, Natacha Martins, Ana Carolina Nunes Botelho, Renata Cristina Picão, Sérgio Eduardo Longo Fracalanzza, Lee Woodland Riley, George Sensabaugh, Beatriz Meurer Moreira
Staphylococcus saprophyticus is an important agent of urinary tract infection (UTI) in young women, but information about this pathogen in human microbiota and in common environment is lacking. The aim of this study was to characterize S. saprophyticus isolates from genitoanal microbiota of 621 pregnant women, 10 minas cheese packs, and five beaches in Rio de Janeiro city and compare PFGE profiles of these isolates with five UTI PFGE clusters described in this city. We investigated 65 S. saprophyticus isolates from microbiota, 13 from minas cheese, and 30 from beaches and 32 UTI isolates...
2017: International Journal of Microbiology
https://www.readbyqxmd.com/read/28630194/pharmacokinetics-safety-and-tolerability-of-single-dose-intravenous-zti-01-and-oral-fosfomycin-in-healthy-volunteers
#14
E Wenzler, E J Ellis-Grosse, K A Rodvold
The pharmacokinetics, safety, and tolerability of intravenous (IV) fosfomycin disodium (ZTI-01) and oral fosfomycin tromethamine were evaluated after a single dose in 28 healthy adult subjects. Subjects received a single 1 hour IV infusion of 1 g and 8 g fosfomycin disodium and a single dose of 3 g oral fosfomycin tromethamine in a phase I, randomized, open-label, three-period crossover study. Serial blood and urine samples were collected before and up to 48 hours after dosing. The mean pharmacokinetic parameters ± standard deviations of fosfomycin in plasma after 1 g and 8 g IV were: Cmax= 44...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28630017/vesicoureteral-reflux-is-a-phenotype-not-a-disease-a-population-centered-approach-to-pediatric-urinary-tract-infection
#15
REVIEW
Jathin Bandari, Steven G Docimo
We performed a review of the recent literature concerning urinary tract infection (UTI) evaluation and management. In modeling options for management, one overriding conclusion became apparent: in most affected children, the presence of vesicoureteral reflux (VUR) is inconsequential since it has no bearing on optimal management or outcome. In fact, knowing that a child does not have reflux might bias the provider to withhold potentially helpful therapeutic modalities to decrease UTI morbidity, such as antibiotic prophylaxis...
May 22, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28629786/-pregnancy-and-delivery-for-women-with-congenital-spinal-cord-defects-and-neurogenic-bladder
#16
Q Manach, M Dommergues, P Denys, K Loiseau, B Idiard-Chamois, E Chartier-Kastler, V Phé
INTRODUCTION: Data are scarce regarding pregnancy and delivery among women with a neurogenic bladder due to congenital spinal cord defects. OBJECTIVE: To report the obstetrical and urological outcomes of women with congenital spinal cord defects and vesico-sphincteric disorders. METHODS: A retrospective multicentric study included all consecutive women with a neurogenic bladder due to congenital spinal defects, who delivered between January 2005 and December 2014...
June 16, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28629757/bacterial-biofilm-based-catheter-associated-urinary-tract-infections-causative-pathogens-and-antibiotic-resistance
#17
Nargis Sabir, Aamer Ikram, Gohar Zaman, Luqman Satti, Adeel Gardezi, Abeera Ahmed, Parvez Ahmed
BACKGROUND: We sought to determine the incidence of bacterial biofilm-based catheter-associated urinary tract infections, identify variables affecting biofilm formation, and identify etiologic bacterial pathogens and antibiotic-resistance patterns associated with biofilm-based catheter-associated urinary tract infections (CAUTIs) in our setup. METHODS: Patients who developed at least 2 symptoms of urinary tract infection after at least 2 days of indwelling urinary catheters were included...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28629241/a-model-to-predict-risk-of-postpartum-infection-after-caesarean-delivery
#18
Laura J Moulton, J Eric Jelovsek, Mark Lachiewicz, Kevin Chagin, Oluwatosin Goje
PURPOSE: To build and validate a statistical model to predict infection after Caesarean delivery (CD). METHODS: Patient and surgical variables within 30 days of CD were collected on 2419 women. Postpartum infection included surgical site infection, urinary tract infection, endomyometritis and pneumonia. The data were split into model development and internal validation (1 Jan - 31 Aug; N=1641) and temporal validation subsets (1 Sept - 31 Dec; N=778). Logistic regression models were fit to the data with concordance index and calibration curves used to assess accuracy...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#19
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28628622/urinary-catheter-associated-microbiota-change-in-accordance-with-treatment-and-infection-status
#20
Laetitia Bossa, Kimberly Kline, Diane McDougald, Bonsan Bonne Lee, Scott A Rice
The use of long-term catheterisation to manage insensate bladders, often associated with spinal cord injury (SCI), increases the risk of microbial colonisation and infection of the urinary tract. Urinary tract infection (UTI) is typically diagnosed and treated based on the culturing of organisms from the urine, although this approach overlooks low titer, slow growing and non-traditional pathogens. Here, we present an investigation of the urinary tract microbiome in catheterised SCI individuals, using T-RFLP and metagenomic sequencing of the microbial community...
2017: PloS One
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