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Healthcare infection

Nikhil Adapa, Nikhil Jain, Allison Capek, Rajiv Chandawarkar, Safdar N Khan, Yazeed M Gussous, Elizabeth Yu
Background: Wound complications can occur in up to 20% of patients following multilevel posterior spinal fusion. Currently, the use of local flaps has been reported in high-risk patients with a history of spinal neoplasm, radiation therapy, exposed hardware, multiple spine surgeries, or wound infections. However, there are no reports of prophylactic muscle flap wound closure in patients undergoing multi-level spinal fusion for degenerative pathology. Given the extensive soft tissue dissection for exposure compounded by patient comorbidities, there is potential to minimize the risk of wound complications with prophylactic trapezius and/or paraspinal flap coverage...
September 2018: Journal of Spine Surgery (Hong Kong)
Alessandro Bidossi, Roberta De Grandi, Marco Toscano, Marta Bottagisio, Elena De Vecchi, Matteo Gelardi, Lorenzo Drago
BACKGROUND: Infections of the ears, paranasal sinuses, nose and throat are very common and represent a serious issue for the healthcare system. Bacterial biofilms have been linked to upper respiratory tract infections and antibiotic resistance, raising serious concerns regarding the therapeutic management of such infections. In this context, novel strategies able to fight biofilms may be therapeutically beneficial and offer a valid alternative to conventional antimicrobials. Biofilms consist of mixed microbial communities, which interact with other species in the surroundings and communicate through signaling molecules...
December 13, 2018: BMC Infectious Diseases
Charlotte F Davies, Joanna M Kesten, Mark Gompels, Jeremy Horwood, Megan Crofts, Annette Billing, Charlotte Chick, Margaret T May
BACKGROUND: HIV-infected patients often present to primary care several times with HIV-indicator conditions before diagnosis but the opportunity to test by healthcare professionals (HCPs) is frequently missed. Current HIV testing rates in primary care are low and educational interventions to facilitate HCPs to increase testing and awareness of HIV are needed. METHOD: We implemented a pilot feasibility stepped-wedged randomised controlled trial of an educational intervention in high HIV prevalence practices in Bristol...
December 13, 2018: BMC Family Practice
Makram E Aljghami, Sundas Saboor, Saeid Amini-Nik
The skin provides a protective barrier to the body against the environment. Ineffective healing of damaged skin can cause a chronic wound which would increase the risk of infection and associated complications. The use of wound dressings to protect the wound and provide an optimal environment for wound repair is a common practice in the burn clinic. While traditional wound healing dressings have substantially changed the wound outcome, wound healing complications are still a challenge to healthcare. Advancements in tissue engineering, biomaterial sciences, and stem cell biology led to the development of novel dressings that not only dress the wounds but also actively contribute to the process of healing...
December 12, 2018: Annals of Biomedical Engineering
Simona Ispas, Samuel So, Mehlika Toy
Chronic hepatitis B infection (CHB) is a condition that needs ongoing care such as monitoring for liver enzymes (ALT) and HBV DNA tests in treated and untreated patients, and annual imaging evaluation for liver cancer. Although follow-up care and treatment might seem straight forward, an estimated two-thirds of those who are aware of their infection are not seeing a health care provider, and more than half of those who are eligible for treatment do not receive it. This study aimed to compile and examine studies related to the barriers of disease monitoring, treatment, and liver cancer surveillance for CHB patients in the United States (US)...
December 11, 2018: Journal of Community Health
Jeanette M Bennett, Glenn Reeves, George E Billman, Joachim P Sturmberg
Siloed or singular system approach to disease management is common practice, developing out of traditional medical school education. Textbooks of medicine describe a huge number of discrete diseases, usually in a systematic fashion following headings like etiology, pathology, investigations, differential diagnoses, and management. This approach suggests that the body has a multitude of ways to respond to harmful incidences. However, physiology and systems biology provide evidence that there is a simple mechanism behind this phenotypical variability...
2018: Frontiers in Medicine
Sarita Manandhar, Anjana Singh, Ajit Varma, Shanti Pandey, Neeraj Shrivastava
S taphylococcus aureus , a notorious human pathogen, is a major cause of the community as well as healthcare associated infections. It can cause a diversity of recalcitrant infections mainly due to the acquisition of resistance to multiple drugs, its diverse range of virulence factors, and the ability to produce biofilm in indwelling medical devices. Such biofilm associated chronic infections often lead to increase in morbidity and mortality posing a high socio-economic burden, especially in developing countries...
2018: Frontiers in Microbiology
Reinier Mutters, Sarah L Warnes
BACKGROUND: Widespread antibiotic resistance has led to fears that we are entering a pre-antibiotic era and the relatively simple premise of hand washing to reduce transfer of bacteria and viruses has never been more important. Much of the emphasis has been on handwashing technique, type of soap and maintaining compliance but effective drying of the hands is just as important. AIM: To compare the efficacy of drying washed hands with a jet air dryer or paper towels to remove transient bacterial contamination and to determine the effect on residential flora...
December 8, 2018: Journal of Hospital Infection
Graham R McClure, Emilie P Belley-Cote, John Harlock, Andre Lamy, Michael Stacey, P J Devereaux, Richard P Whitlock
PURPOSE: Postoperative infection, particularly in cardiac surgery, results in significant morbidity, mortality, and healthcare cost. Identification of novel predictors of postoperative infection can target high-risk populations for prophylactic intervention. METHODS: Steroids in cardiac surgery (SIRS) was a multi-centre randomized-controlled trial assessing intraoperative administration of methylprednisone during cardiac surgery, which enrolled 7,507 patients across 80 centres in 18 countries...
December 10, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Antoine Grosset, Philippe Mangin, Christine MacNab, Georges Pfister, Nicolas de l'Escalopier, Jean-Marie Cournac, Marc Aletti, Thierry Samson, Sylvain Rigal, Laurent Mathieu
Introduction: Extremity war-wounds present an elevated risk of infection and compromise reconstructive procedures. In a French military hospital, a multi-disciplinary meeting (MDM) was created to standardize the care given to soldiers with osteoarticular infection. The aim of this study was to evaluate the usefulness of MDM decisions. Methods: An observational case study was performed including the French wounded at war treated for an osteoarticular infection between 2004 and 2016...
December 7, 2018: Military Medicine
Alicen B Spaulding, Dave Watson, Jill Dreyfus, Phillip Heaton, Steven Grapentine, Ellen Bendel-Stenzel, Anupam Kharbanda
Background: Bloodstream infections (BSIs) cause significant morbidity and mortality in children. Recent pediatric epidemiological data may inform prevention strategies and empiric antimicrobial therapy selection. Methods: We conducted a retrospective cohort study from 2009-2016 utilizing demographic and microbiology data on inpatients <19 years using the Premier Healthcare Database. BSIs were positive blood cultures without known contaminants. Hospitalization rate was the number of BSI-positive encounters per 1,000 admissions...
December 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Laura Espenhain, Silje Bakken Jørgensen, Truls Michael Leegaard, Michaela Marie Lelek, Siri Haug Hänsgen, Britt Nakstad, Marianne Sunde, Martin Steinbakk
Background: We aimed to estimate the prevalence of faecal carriage of extended-spectrum cephalosporin (ESC) resistant E. coli and K. pneumoniae (ESCr-EK) and vancomycin resistant enterococci (VRE) in patients upon hospital admission and identify factors associated with carriage to better target interventions and to guide empirical antibiotic treatment. Methods: Between October 2014 and December 2016, we recruited patients admitted to a Norwegian university hospital...
2018: Antimicrobial Resistance and Infection Control
Won Suk Choi, Su Hyun Kim, Dae Won Park
Background: Pertussis is highly contagious respiratory disease. Healthcare workers (HCWs) can be an important mediator of the disease. A seroprevalence of pertussis was investigated in HCWs to determine the immune status against pertussis and to detect the unidentified pertussis. Methods: This study was conducted for HCWs at a hospital located in Korea in 2011. After obtaining written informed consent for HCWs voluntarily participating in the study, 10 mL of blood was collected from each subject...
December 10, 2018: Journal of Korean Medical Science
Mahmoud E Elrggal, Nedaa A Karami, Bushra Rafea, Lama Alahmadi, Anwar Al Shehri, Ruba Alamoudi, Hassan Koshak, Saad Alkahtani, Ejaz Cheema
Aim: To assess the knowledge and attitude of senior medical, dental, nursing and pharmacy students toward Middle East respiratory syndrome-corona virus (MERS-CoV) in Saudi Arabia. Subjects and methods: A cross-sectional survey using a 21-item questionnaire was conducted for a 3-month period from November 2015-January 2016 in Makkah, Saudi Arabia. The questionnaire was designed to evaluate students' understanding and perception of MERS-CoV. An ANOVA test was used to determine the association of study discipline and academic year with the student knowledge score on MERS...
2018: Journal of Public Health
Janet Saul, Gretchen Bachman, Shannon Allen, Nora F Toiv, Caroline Cooney, Ta'Adhmeeka Beamon
In sub-Saharan Africa, adolescent girls and young women (AGYW) are 5 to 14 times more likely to be infected with HIV than their male peers. Every day, more than 750 AGYW are infected with HIV. Many factors make girls and young women particularly vulnerable to HIV, including gender-based violence, exclusion from economic opportunities, and a lack of access to secondary school. The President's Emergency Plan for AIDS Relief (PEPFAR) is dedicating significant resources through the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) partnership to impact the lives of women and girls based on PEPFAR's mission to help countries achieve epidemic control of HIV/AIDS...
2018: PloS One
Lucy Platt, Pippa Grenfell, Rebecca Meiksin, Jocelyn Elmes, Susan G Sherman, Teela Sanders, Peninah Mwangi, Anna-Louise Crago
BACKGROUND: Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers' safety, health, and access to services, and the pathways through which these effects occur. METHODS AND FINDINGS: We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health...
December 2018: PLoS Medicine
Brecht Ingelbeen, Nadine A Weregemere, Harold Noel, Gaston P Tshapenda, Mathias Mossoko, Justus Nsio, Axelle Ronsse, Steve Ahuka-Mundeke, Sandra Cohuet, Benoît I Kebela
BACKGROUND: Between December 2015 and July 2016, a yellow fever (YF) outbreak affected urban areas of Angola and the Democratic Republic of the Congo (DRC). We described the outbreak in DRC and assessed the accuracy of the YF case definition, to facilitate early diagnosis of cases in future urban outbreaks. METHODOLOGY/PRINCIPAL FINDINGS: In DRC, suspected YF infection was defined as jaundice within 2 weeks after acute fever onset and was confirmed by either IgM serology or PCR for YF viral RNA...
December 7, 2018: PLoS Neglected Tropical Diseases
Sonali Wayal, Catherine R H Aicken, Catherine Griffiths, Paula B Blomquist, Gwenda Hughes, Catherine H Mercer
BACKGROUND: In the UK, people of black Caribbean (BC) ethnicity continue to be disproportionately affected by bacterial sexually transmitted infections (STIs) and Trichomonas vaginalis (TV). We systematically reviewed evidence on the association between bacterial STIs/TV and ethnicity (BC compared to white/white British (WB)) accounting for other risk factors; and differences between these two ethnic groups in the prevalence of risk factors associated with these STIs, sexual healthcare seeking behaviours, and contextual factors influencing STI risk...
2018: PloS One
Md Anisur Rahman, Marpe Bam, Edgar Luat, Moumita Sharmin Jui, Mitra S Ganewatta, Tinom Shokfai, Mitzi Nagarkatti, Alan W Decho, Chuanbing Tang
Bacterial infections and antibiotic resistance, particularly by Gram-negative pathogens, have become a global healthcare crisis. We report the design of a class of cationic antimicrobial polymers that cluster local facial amphiphilicity from repeating units to enhance interactions with bacterial membranes without requiring a globally conformational arrangement associated with highly unfavorable entropic loss. This concept of macromolecular architectures is demonstrated with a series of multicyclic natural product-based cationic polymers...
December 7, 2018: Nature Communications
Paul Spearman, Yvonne Bryson
PURPOSE OF REVIEW: The purpose of this review is to describe some current challenges facing the field of pediatric infectious diseases and discuss strategies for enhancing recognition of the value of infectious disease services and for recruiting new talent to the field. RECENT FINDINGS: Pediatric infectious disease programs are currently filling approximately half of their fellowship positions, and salaries are among the lowest in medical subspecialties. Research-intensive careers in pediatric infectious diseases are threatened by low the National Institutes of Health paylines for career development awards...
December 10, 2018: Current Opinion in Pediatrics
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