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https://www.readbyqxmd.com/read/28333257/comparative-effectiveness-of-linezolid-versus-vancomycin-as-definitive-antibiotic-therapy-for-heterogeneously-resistant-vancomycin-intermediate-coagulase-negative-staphylococcal-central-line-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#1
A C Blanchard, E Fortin, C Laferrière, I Goyer, A Moussa, J Autmizguine, C Quach
Objectives: Heterogeneously resistant vancomycin-intermediate coagulase-negative staphylococci (hVICoNS) are emerging pathogens causing central-line-associated bloodstream infections (CLABSIs) in neonatal intensive care unit (NICU) patients. Given the burden of disease associated with CLABSI and the current lack of therapeutic guidelines, we aimed to compare the effectiveness of linezolid versus vancomycin used as the definitive antibiotic therapy for hVICoNS CLABSI. Methods: We performed a retrospective cohort study of infants with hVICoNS CLABSI from a single NICU between 2009 and 2014, treated with either linezolid or vancomycin as definitive antibiotic therapy...
March 3, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28330865/an-automated-smartphone-based-diagnostic-assay-for-point-of-care-semen-analysis
#2
Manoj Kumar Kanakasabapathy, Magesh Sadasivam, Anupriya Singh, Collin Preston, Prudhvi Thirumalaraju, Maanasa Venkataraman, Charles L Bormann, Mohamed Shehata Draz, John C Petrozza, Hadi Shafiee
Male infertility affects up to 12% of the world's male population and is linked to various environmental and medical conditions. Manual microscope-based testing and computer-assisted semen analysis (CASA) are the current standard methods to diagnose male infertility; however, these methods are labor-intensive, expensive, and laboratory-based. Cultural and socially dominated stigma against male infertility testing hinders a large number of men from getting tested for infertility, especially in resource-limited African countries...
March 22, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28330409/guidelines-on-constructing-funnel-plots-for-quality-indicators-a-case-study-on-mortality-in-intensive-care-unit-patients
#3
Ilona Wm Verburg, Rebecca Holman, Niels Peek, Ameen Abu-Hanna, Nicolette F de Keizer
Funnel plots are graphical tools to assess and compare clinical performance of a group of care professionals or care institutions on a quality indicator against a benchmark. Incorrect construction of funnel plots may lead to erroneous assessment and incorrect decisions potentially with severe consequences. We provide workflow-based guidance for data analysts on constructing funnel plots for the evaluation of binary quality indicators, expressed as proportions, risk-adjusted rates or standardised rates. Our guidelines assume the following steps: (1) defining policy level input; (2) checking the quality of models used for case-mix correction; (3) examining whether the number of observations per hospital is sufficient; (4) testing for overdispersion of the values of the quality indicator; (5) testing whether the values of quality indicators are associated with institutional characteristics; and (6) specifying how the funnel plot should be constructed...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28328270/end-of-life-care-guidelines-and-care-plans-in-the-intensive-care-unit
#4
Alison Luckett
The aim of this literature review was to examine end-of-life (EoL) care practice in the intensive care unit (ICU). By exploring the literature, it is hoped to suggest how national guidance can be integrated into the ICU setting. Delivering high-quality, patient-centred EoL care is high priority on the UK health agenda. The highly technological environment within the ICU can create barriers to recognising death and initiating EoL care planning. Despite recommendations in the literature for the integration of standardised guidance, implementation, compliance and evaluation are yet to be widely reported...
March 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#5
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28321786/adherence-to-pediatric-diabetic-ketoacidosis-guidelines-by-community-emergency-departments-providers
#6
Janine E Zee-Cheng, Emily C Webber, Samer Abu-Sultaneh
BACKGROUND: Diabetic ketoacidosis (DKA) is a common presentation of type I diabetes mellitus to the emergency departments. Most children with DKA are initially managed in community emergency departments where providers may not have easy access to educational resources or pediatric-specific guidelines and protocols that are readily available at pediatric academic medical centers. The aim of this study is to evaluate adherence of community emergency departments in the state of Indiana to the pediatric DKA guidelines...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28320459/risk-factors-for-pressure-injury-development-in-critically-ill-patients-in-the-intensive-care-unit-a-systematic-review-protocol
#7
Fiona Coyer, Nahla Tayyib
BACKGROUND: Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population...
March 20, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28320238/early-renal-replacement-therapy-versus-standard-care-in-the-icu
#8
Dipayan Chaudhuri, Brent Herritt, Daren Heyland, Louis-Philippe Gagnon, Kednapa Thavorn, Daniel Kobewka, Kwadwo Kyeremanteng
OBJECTIVE: Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#9
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28304316/perspectives-and-attitudes-of-pediatricians-concerning-post-discharge-care-practice-of-premature-infants
#10
A Gad, E Parkinson, N Khawar, A Elmeki, P Narula, D Hoang
OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28302347/fungemia-due-to-saprochaete-capitata-in-a-non-neutropenic-patient-hospitalized-in-an-intensive-care-unit-after-cardiac-surgery
#11
C Cavanna, F Lallitto, F Mangione, F Tamarozzi, P Marone, P Ceriana
The majority of invasive fungal infections observed in non-neutropenic patients hospitalized in an intensive care unit are caused by Candida spp and current guidelines recommend echinocandins as the first-line treatment. Fungemias caused by filamentous or arthrosporic fungi such as Saprochaete capitata (previously named Geotrichum capitatum) are extremely rare. In fact, invasive infections due to S. capitata have been reported almost exclusively in neutropenic oncohematological patients. In this report, we describe a case of fungemia caused by S...
March 14, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28298858/mobile-unit-for-retinopathy-of-prematurity-screening-and-management-at-urban-neonatal-intensive-care-units-outcomes-and-impact-assessment
#12
Jai Kelkar, Supriya Agashe, Aditya Kelkar, Rajiv Khandekar
PURPOSE: To study the outcomes and impact of a mobile unit for retinopathy of prematurity (ROP) screening and management at urban Neonatal Intensive Care Units (NICUs). STUDY DESIGN: Public health intervention study. METHODS: This study was conducted in 2012. Staff of a mobile unit assessed all infants aged 32 weeks or less and/or weight 1250 g or less admitted in five NICUs between 2009 and 2011. An ophthalmologist performed bedside ROP screening through dilated pupils using indirect ophthalmoscopy...
January 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28295397/red-blood-cell-transfusions-can-induce-proinflammatory-cytokines-in-preterm-infants
#13
Carlo Dani, Chiara Poggi, Elena Gozzini, Valentina Leonardi, Alice Sereni, Rosanna Abbate, Anna Maria Gori
BACKGROUND: The risk of developing red blood cell (RBC) transfusion-associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect. STUDY DESIGN AND METHODS: We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n = 20) admitted to a tertiary neonatal intensive care unit...
March 11, 2017: Transfusion
https://www.readbyqxmd.com/read/28292006/radiotherapy-in-prostate-cancer-treatment-results-of-the-patterns-of-care-study-in-korea
#14
Ah Ram Chang, Won Park
Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013...
March 17, 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#15
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289668/the-efficacy-of-laparoscopic-cholecystectomy-without-discontinuation-in-patients-on-antithrombotic-therapy
#16
Jong Hyuk Yun, Hae Il Jung, Hyoung Uk Lee, Moo-Jun Baek, Sang Ho Bae
PURPOSE: Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy. METHODS: We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28288860/epidemiology-of-multidrug-resistant-gram-negative-pathogens-isolated-from-ventilator-associated-pneumonia-in-icu-patients
#17
Richa Gupta, Abida Malik, Meher Rizvi, Moied Ahmed, Anuradha Singh
OBJECTIVES: Antibiotic resistance among Gram-negative pathogens isolated from ventilator-associated pneumonia (VAP) poses a grave threat in intensive care unit (ICU) patients. The aim of this study was to assess the prevalence of pathogens in ICU patients and their drug resistance profile. The prevalence of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and metallo-β-lactamases (MBLs) was also assessed. METHODS: Tracheal aspirates were collected aseptically from 87 ICU patients between May 2012 and January 2014...
March 10, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28287931/assessment-and-characterization-of-sound-pressure-levels-in-portuguese-neonatal-intensive-care-units
#18
Joana Santos, Carlos Carvalhais, Ana Xavier, Manuela V Silva
In NICU, systematic exposure to sound pressure levels above the recommended can affect both neonates and staff. This study aimed to evaluate the sound pressure levels in three Portuguese NICU and the noise perception of staff. The measurements were performed with a sound level meter, considering the location of the main sources of noise and the layout of the units. A questionnaire was applied to assess noise perception of professionals. The staff classified the environment (regarding noise) as "slightly uncomfortable" (41...
March 13, 2017: Archives of Environmental & Occupational Health
https://www.readbyqxmd.com/read/28285322/intensive-care-medicine-research-agenda-on-cardiac-arrest
#19
REVIEW
Jerry P Nolan, Robert A Berg, Stephen Bernard, Bentley J Bobrow, Clifton W Callaway, Tobias Cronberg, Rudolph W Koster, Peter J Kudenchuk, Graham Nichol, Gavin D Perkins, Tom D Rea, Claudio Sandroni, Jasmeet Soar, Kjetil Sunde, Alain Cariou
Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)-requiring mechanical ventilation and sedation-and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care...
March 11, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28285032/the-association-between-physician-turnover-the-july-effect-and-survival-after-in-hospital-cardiac-arrest
#20
Laura Myers, Bassem Mikhael, Paul Currier, Katherine Berg, Anupam Jena, Michael Donnino, Lars W Andersen
IMPORTANCE: The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. OBJECTIVE: As a surrogate for physician turnover, we used a multivariable difference-in-difference approach to determine if there was a difference in outcomes between May and July in teaching versus non-teaching hospitals. DESIGN: We used prospectively collected observational data from United States hospitals participating in the Get With The Guidelines(®)-Resuscitation registry...
March 8, 2017: Resuscitation
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