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https://www.readbyqxmd.com/read/29451055/early-discontinuation-of-empirical-antibacterial-therapy-in-febrile-neutropenia-the-antibiostop-study
#1
Lenaïg Le Clech, Jean-Philippe Talarmin, Marie-Anne Couturier, Jean-Christophe Ianotto, Christophe Nicol, Ronan Le Calloch, Stéphanie Dos Santos, Pascal Hutin, Didier Tandé, Virginie Cogulet, Christian Berthou, Gaëlle Guillerm
INTRODUCTION: Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES: The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia...
February 16, 2018: Infectious Diseases
https://www.readbyqxmd.com/read/29450194/avoiding-arterial-hypotension-in-preterm-neonates-ahip-a-single-center-randomised-controlled-study-investigating-simultaneous-near-infrared-spectroscopy-measurements-of-cerebral-and-peripheral-regional-tissue-oxygenation-and-dedicated-interventions
#2
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29447109/sepsis-2018-definitions-and-guideline-changes
#3
Lena M Napolitano
BACKGROUND: Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. DISCUSSION: New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis...
February 2018: Surgical Infections
https://www.readbyqxmd.com/read/29445505/the-japanese-clinical-practice-guidelines-for-management-of-sepsis-and-septic-shock-2016-j-sscg-2016
#4
Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda
Background and Purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29445299/choosing-wisely-after-publication-of-level-i-evidence-in-breast-cancer-radiotherapy
#5
Joshua R Niska, Sameer R Keole, Barbara A Pockaj, Michele Y Halyard, Samir H Patel, Donald W Northfelt, Richard J Gray, Nabil Wasif, Carlos E Vargas, William W Wong
Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT...
2018: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/29441500/the-epidemiology-of-clostridium-difficile-infection-in-japan-a-systematic-review
#6
REVIEW
Thomas V Riley, Tomomi Kimura
To increase understanding of the epidemiology, risks, consequences and resource utilization of Clostridium difficile infection (CDI) in Japan, a systematic literature review was undertaken of relevant publications from January 2006 to November 2017. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and methods, 55 articles met the criteria for full review. The majority (58%) of studies were from a single site, with the most recent data from 2015. The incidence, reported prevalence and recurrence rate of CDI in Japan were 0...
February 13, 2018: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29440909/clinical-characteristics-patterns-of-lipid-lowering-medication-use-and-health-care-resource-utilization-and-costs-among-patients-with-atherosclerotic-cardiovascular-disease
#7
Thomas P Power, Xuehua Ke, Zhenxiang Zhao, Nicole Gidaya Bonine, Mark J Cziraky, Michael Grabner, John J Barron, Ralph Quimbo, Burkhard Vangerow, Peter P Toth
Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29437075/changing-the-time-of-blood-collection-to-determine-vancomycin-concentrations-in-intensive-care-unit-patients
#8
Drayton A Hammond, Taylor B James, Lexis N Atkinson, Jacob T Painter, Katherine Lusardi
BACKGROUND: Clinical practice guidelines for initiation and therapeutic drug monitoring, but not timing, of vancomycin dosing exist at many institutions. Scheduling vancomycin trough measurements and doses around the morning blood sample collection could yield more interpretable troughs and increase patient safety. OBJECTIVE: To evaluate the appropriateness of blood sample collection times for vancomycin trough measurements before and after an initiative to change the timing of blood sampling to determine vancomycin doses and trough levels in a medical intensive care unit...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29435330/the-japanese-clinical-practice-guidelines-for-management-of-sepsis-and-septic-shock-2016-j-sscg-2016
#9
Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda
Background and purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] 10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29433814/acute-symptomatic-seizures-in-term-neonates-etiologies-and-treatments
#10
Janet S Soul
Acute symptomatic seizures caused by either diffuse or focal perinatal hypoxic-ischemic insults and intracranial hemorrhage in term newborns make up the large majority of all neonatal seizures. Acute seizures are one of the most common neurological disorders in term newborns who require admission to the neonatal intensive care unit. Despite elucidation of seizure pathogenesis in this population using animal models, treatment is limited by a lack of good evidence-based guidelines because of a paucity of rigorously conducted clinical trials or prospective studies in human newborns...
February 6, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29431872/interventions-to-prevent-hypothermia-at-birth-in-preterm-and-or-low-birth-weight-infants
#11
REVIEW
Emma M McCall, Fiona Alderdice, Henry L Halliday, Sunita Vohra, Linda Johnston
BACKGROUND: Newborn admission temperature is a strong predictor of outcomes across all gestations. Hypothermia immediately after birth remains a worldwide issue and, if prolonged, is associated with harm. Keeping preterm infants warm is difficult even when recommended routine thermal care guidelines are followed in the delivery room. OBJECTIVES: To assess the efficacy and safety of interventions designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room, compared with routine thermal care or any other single/combination of intervention(s) also designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room...
February 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29431134/smoking-cessation-support-for-regular-smokers-in-hungarian-primary-care-a-nationwide-representative-cross-sectional-study
#12
Valéria Sipos, Anita Pálinkás, Nóra Kovács, Karola Orsolya Csenteri, Ferenc Vincze, József Gergő Szőllősi, Tibor Jenei, Magor Papp, Róza Ádány, János Sándor
OBJECTIVES: Our study aimed to evaluate the effectiveness of general practitioners' (GPs') smoking cessation support (SCS). STUDY DESIGN: We carried out a cross-sectional study between February and April 2016. SETTING AND PARTICIPANT: A sample of 2904 regular smokers aged 18 years or older was selected randomly from 18 general medical practices involved in a national representative, general medical practice-based morbidity monitoring system...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29430749/patterns-of-use-of-near-infrared-spectroscopy-in-neonatal-intensive-care-units-international-usage-survey
#13
Carol Lu Hunter, Ju Lee OeI, Keiji Suzuki, Kei Lui, Timothy Schindler
AIM: To assess uptake and applications of near-infrared spectroscopy (NIRS) by neonatal intensive care units (NICUs). METHODS: A pre-piloted online questionnaire was distributed in May 2015 to 12 perinatal societies in Asia, Europe, Australasia, North America, and Middle East for dissemination to NICUs. Questions surveyed demographics, NIRS research/clinical applications, usage frequency, training approaches, and target infant populations. RESULTS: In total, 255 responses from 235 NICUs were obtained...
February 11, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29426359/twenty-weeks-of-isometric-handgrip-home-training-to-lower-blood-pressure-in-hypertensive-older-adults-a-study-protocol-for-a-randomized-controlled-trial
#14
Martin Grønbech Jørgensen, Jesper Ryg, Mathias Brix Danielsen, Pascal Madeleine, Stig Andersen
BACKGROUND: Hypertension markedly increases the risk of cardiovascular diseases and overall mortality. Lifestyle modifications, such as increased levels of physical activity, are recommended as the first line of anti-hypertensive treatment. A recent systematic review showed that isometric handgrip (IHG) training was superior to traditional endurance and strength training in lowering resting systolic blood pressure (SBP). The average length of previous IHG training studies is approximately 7...
February 9, 2018: Trials
https://www.readbyqxmd.com/read/29426052/-ssc-international-guideline-2016-management-of-sepsis-and-septic-shock
#15
Tim Rahmel
The new guideline of the Surviving Sepsis Campaign was revised in 2016 and presented in 2017. Furthermore, "Sepsis-3" in 2016 completely changed the definition of Sepsis from inflammation plus infection to a "life-threatening organ dysfunction caused by a dysregulated host response". To cope with the great challenge to unite the new evidence of sepsis treatment with the new definition of sepsis, the guidelines have been completely reconstructed and comprehensively deal with new evidence...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29425516/reprint-of-building-a-safer-and-faster-car-seatbelts-airbags-and-crispr
#16
REVIEW
Miguel-Angel Perales, Partow Kebriaei, Leslie S Kean, Michel Sadelain
Therapeutic T cell engineering has recently garnered widespread interest because of the success of CD19 chimeric antigen receptor (CAR) therapy. CARs are synthetic receptors for antigen that redirect the specificity and reprogram the function of the T cells in which they are genetically introduced. CARs targeting CD19, a cell surface molecule found in most leukemias and lymphomas, have yielded high remission rates in patients with chemorefractory, relapsed disease, including acute lymphoblastic leukemia, chronic lymphocytic leukemia, and non-Hodgkin lymphoma...
March 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29423912/implementing-and-assessing-a-standardized-protocol-for-weaning-children-successfully-from-extracorporeal-life-support
#17
Rouven Kubicki, René Höhn, Jochen Grohmann, Thilo Fleck, Katja Reineker, Johannes Kroll, Matthias Siepe, Christoph Benk, Rolf Klemm, Frank Humburger, Brigitte Stiller
Extracorporeal life support (ECLS) weaning is a complex interdisciplinary process with no clear guidelines. To assess ventricular and pulmonary function as well as hemodynamics including end-organ recovery during ECLS weaning, we developed a standardized weaning protocol. We reviewed our experience 2 years later to assess its feasibility and efficacy. In 2015 we established an inter-professional, standardized, stepwise protocol for weaning from ECLS. If the patient did not require further surgery, weaning was conducted bedside in the intensive care unit (ICU)...
February 8, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29422174/efficacy-of-a-care-bundle-to-prevent-multiple-infections-in-the-intensive-care-unit-a-quasi-experimental-pretest-posttest-design-study
#18
Gulay Yazici, Hulya Bulut
BACKGROUND: Healthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates. OBJECTIVES: To evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections. MATERIALS AND METHOD: This quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29417215/organ-and-tissue-donation-in-a-regional-paediatric-intensive-care-unit-evaluation-of-practice
#19
Laura Carone, Shrirang Alurkar, Phoebe Kigozi, Harish Vyas
Approximately 2% of those on the organ transplant list in the UK are children. Early identification of donors and referral to organ donation teams (ODT) has proven to increase both the success rate of gaining consent and the number of organs actually retrieved. To evaluate the practice relating to organ donation for children receiving end-of-life care on a paediatric intensive care unit (PICU) measured against the National Guidelines. All children 0-18 who received their end-of-life care and died on the PICU...
February 7, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29413727/addressing-spirituality-during-critical-illness-a-review-of-current-literature
#20
REVIEW
Barbara S Gordon, Maggie Keogh, Zachary Davidson, Stephen Griffiths, Vanshdeep Sharma, Deborah Marin, Stephan A Mayer, Neha S Dangayach
OBJECTIVES: The purpose of this review is to provide an overview of research on spirituality and religiosity in the intensive care setting that has been published since the 2004-2005 American College of Critical Care Medicine (ACCM) Clinical Practice Guidelines for the Support of Family in the Patient-Centered Intensive Care Unit with an emphasis on its application beyond palliative and end-of-life care. MATERIALS AND METHODS: ACCM 2004-2005 guidelines emphasized the importance of spiritual and religious support in the form of four specific recommendations: [1] assessment and incorporation of spiritual needs in ICU care plan; [2] spiritual care training for doctors and nurses; [3] physician review of interdisciplinary spiritual need assessments; and [4] honoring the requests of patients to pray with them...
January 31, 2018: Journal of Critical Care
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