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https://www.readbyqxmd.com/read/28350642/increased-early-systemic-inflammation-in-icu-acquired-weakness-a-prospective-observational-cohort-study
#1
Esther Witteveen, Luuk Wieske, Tom van der Poll, Marike van der Schaaf, Ivo N van Schaik, Marcus J Schultz, Camiel Verhamme, Janneke Horn
OBJECTIVES: To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness. DESIGN: Prospective observational cohort study. SETTING: Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands. PATIENTS: Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#2
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28346504/diagnostic-accuracy-of-two-multiplex-real-time-polymerase-chain-reaction-assays-for-the-diagnosis-of-meningitis-in-children-in-a-resource-limited-setting
#3
Jermaine Khumalo, Mark Nicol, Diana Hardie, Rudzani Muloiwa, Phindile Mteshana, Colleen Bamford
INTRODUCTION: Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. METHODS: We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H...
2017: PloS One
https://www.readbyqxmd.com/read/28345309/a-survey-of-clinicians-regarding-respiratory-physiotherapy-intervention-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-what-is-current-practice-in-australian-icus
#4
Lisa van der Lee, Anne-Marie Hill, Shane Patman
RATIONALE, AIMS, AND OBJECTIVES: Community-acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency...
March 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28343224/the-evidence-of-acute-kidney-injury-in-the-community-and-for-primary-care-interventions
#5
Lauren Emmett, James Tollitt, Sheila McCorkindale, Smeeta Sinha, Dimitrios Poulikakos
BACKGROUND: Almost two-thirds of patients with acute kidney injury (AKI) damage their kidneys whilst in the community. This paper aims to review existing data on incidence, mortality, and morbidity of AKI within the community and explore the evidence base for primary care strategies aimed at reducing incidence and improving early detection and management of AKI. METHODS: A literature search was carried out using PubMed; key words including AKI, primary care, community acquired, and electronic alerts (e-alerts) were used to capture relevant data...
March 25, 2017: Nephron
https://www.readbyqxmd.com/read/28343204/-risk-management-of-hospital-infections-as-a-supporting-tool-for-the-improvement-of-hospital-quality-some-european-examples
#6
Mateusz Sitek, Izabela Witczak, Dorota Kiedik
Prevention and control of nosocomial infections is one of the main pillars of security in each medical facility. This affects the quality of services and helps to minimize the economic losses incurred as a result of such infections. (Prolonged hospitalization, expensive antibiotic therapies, court costs of damages). Nosocomial infections occur in every medical facility in the hospitals in terms of risk of infection compared to other medicinal entities are at greater risk of environmental (number of hospitalizations for one bed, the amount of disinfectants, etc...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28341612/impact-of-%C3%AE-lactam-antibiotic-therapeutic-drug-monitoring-on-dose-adjustments-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy
#7
Caleb J P Economou, Gloria Wong, Brett McWhinney, Jacobus P J Ungerer, Jeffrey Lipman, Jason A Roberts
The objective of this study was to describe the effect of therapeutic drug monitoring (TDM) and dose adjustments of β-lactam antibiotics administered to critically ill patients undergoing continuous renal replacement therapy (CRRT) in a 30-bed tertiary intensive care unit (ICU). β-Lactam TDM data in our tertiary referral ICU were retrospectively reviewed. Clinical, demographic and dosing data were collected for patients administered β-lactam antibiotics while undergoing CRRT. The target trough concentration range was 1-10× the minimum inhibitory concentration (MIC)...
March 21, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#8
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339727/rapid-decrease-in-rates-of-hospitalization-resulting-from-invasive-pneumococcal-disease-and-community-acquired-pneumonia-in-children-aged-60-months-after-13-valent-pneumococcal-conjugate-vaccine-introduction-in-argentina
#9
Eduardo L López, Eduardo Glatstein, Gustavo C Ezcurra, Marisa Iacono, Eduardo Teplitz, Analía V Garnero, Daniela L Lazzarini, Miryan Vázquez, María M Contrini
Background.: In January 2012, Argentina included universal pneumococcal vaccination in the routine childhood vaccination program using a 13-valent pneumococcal conjugate vaccine (PCV13). A 2 + 1 schedule (2 doses in the first year of life and a booster dose at 12 months of age) in children aged <2 years and 2-dose catch-up immunization in children aged 13 to 24 months was administered during the first year of vaccine introduction. The purpose of this study was to assess the burdens of invasive pneumococcal disease (IPD) and/or community-acquired pneumonia (CAP) in hospitalized children younger than 5 years during the first 2 years of the program compared to those in the prevaccination period in our setting...
February 23, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28338911/new-horizons-in-hospital-acquired-pneumonia-in-older-people
#10
Victoria Ewan, Thomas Hellyer, Julia Newton, John Simpson
Approximately 1.5% of hospital patients develop hospital acquired pneumonia. Aspiration is the major risk factor for pneumonia and is associated with reduced ability to mechanically clear respiratory pathogens into the stomach. Currently non-invasive methods of diagnosing hospital acquired pneumonia are less robust than invasive methods, and lead to over-diagnosis. Accurate diagnosis is key to surveillance, prevention and treatment of HAP, and also to improving outcomes; newer imaging modalities such as phase contrast X-ray imaging and nanoparticle enhanced magnetic resonance imaging may help...
February 27, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28337699/lung-ultrasound-is-comparable-with-chest-roentgenogram-for-diagnosis-of-community-acquired-pneumonia-in-hospitalised-children
#11
Krishna Kumar Yadav, Shally Awasthi, Anit Parihar
OBJECTIVE: To evaluate the accuracy of lung ultrasound (LUS) in comparison to chest roentgenogram (CXR) in hospitalised children with community-acquired pneumonia (CAP). METHODS: This study was a hospital based prospective observational study, conducted between January 2014 and December 2014. Hospitalised children aged 2 to 59 mo with community-acquired pneumonia were included in the study. The informed written consent was taken from parents (or legal guardian) before recruitment...
March 24, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28337457/screening-for-tuberculosis-in-health-care-workers-experience-in-an-italian-teaching-hospital
#12
Christian Napoli, Filippo Ferretti, Filippo Di Ninno, Riccardo Orioli, Alessandra Marani, Maria Giuditta Sarlo, Claudio Prestigiacomo, Assunta De Luca, Giovanni Battista Orsi
Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Therefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it suffers of low specificity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specificity and sensitivity but are more expensive. The present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as first- and second-level screening tests, respectively...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28336597/draft-genome-sequence-of-providencia-stuartii-ps71-a-multidrug-resistant-strain-associated-with-nosocomial-infections-in-greece
#13
A Liakopoulos, O Oikonomou, D W Wareham
Providencia stuartii is frequently associated with nosocomial outbreaks and displays intrinsic resistance to many commonly used antimicrobials. We report here the draft genome sequence of a P. stuartii strain carrying acquired resistance genes conferring panresistance to cephalosporins (blaSHV-5 and blaVEB-1), carbapenems (blaVIM-1), and aminoglycosides (rmtB) involved in an outbreak in Greek hospitals.
March 23, 2017: Genome Announcements
https://www.readbyqxmd.com/read/28336384/predictors-for-individual-patient-antibiotic-treatment-effect-in-hospitalised-community-acquired-pneumonia-patients
#14
Antonella F Simonetti, Cornelis H van Werkhoven, Valentijn A Schweitzer, Diego Viasus, Jordi Carratalà, Douwe F Postma, Jan Jelrik Oosterheert, Marc J M Bonten
OBJECTIVE: Our objective was to identify clinical predictors of antibiotic treatment effects in non-ICU hospitalised CAP patients. METHODS: Post-hoc analysis of three prospective cohorts (from the Netherlands and Spain) of CAP adult patients admitted to a non-ICU having received either beta-lactam monotherapy (BL), beta-lactam + macrolide (BLM), or fluoroquinolone-based therapy (FQL) as empiric antibiotic treatment. We evaluated candidate clinical predictors of treatment effects in multiple mixed-effects models by including interactions of the predictors with empiric antibiotic choice and using 30-day mortality, ICU admission, and length of hospital stay (LOS) as outcomes...
March 20, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28335807/time-dependent-association-of-glucocorticoids-with-adverse-outcome-in-community-acquired-pneumonia-a-6-year-prospective-cohort-study
#15
Manuela Nickler, Manuel Ottiger, Christian Steuer, Alexander Kutz, Mirjam Christ-Crain, Werner Zimmerli, Robert Thomann, Claus Hoess, Christoph Henzen, Luca Bernasconi, Andreas Huber, Beat Mueller, Philipp Schuetz
BACKGROUND: The hypothalamic-pituitary-adrenal stress axis plays a crucial role in community-acquired pneumonia (CAP), with high cortisol being associated with disease severity and corticosteroid treatment resulting in earlier time to recovery. Our aim in the present study was to compare different glucocorticoid hormones, including cortisol, 11-deoxycortisol, cortisone, and corticosterone, regarding their association with short- and long-term adverse outcomes in a well-defined CAP cohort...
March 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28335406/factors-that-negatively-affect-the-prognosis-of-pediatric-community-acquired-pneumonia-in-district-hospital-in-tanzania
#16
Serena Caggiano, Nicola Ullmann, Elisa De Vitis, Marzia Trivelli, Chiara Mariani, Maria Podagrosi, Fabiana Ursitti, Chiara Bertolaso, Carolina Putotto, Marta Unolt, Andrea Pietravalle, Paola Pansa, Kajoro Mphayokulela, Maria Incoronata Lemmo, Michael Mkwambe, Joseph Kazaura, Marzia Duse, Francesco Nieddu, Chiara Azzari, Renato Cutrera
Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died...
March 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28334885/full-volume-isotonic-0-9-vs-two-thirds-volume-hypotonic-0-18-intravenous-maintenance-fluids-in-preventing-hyponatremia-in-children-admitted-to-pediatric-intensive-care-unit-a-randomized-controlled-study
#17
Raksha S K, B Dakshayani, Premalatha R
Background: : We aimed to compare the effect of two different intravenous fluid regimes on the incidence of hyponatremia in children. Methods: : Children 1 month to 18 years of age, admitted to pediatric intensive care unit (PICU) of a tertiary care medical college hospital were randomized to receive either isotonic fluid (0.9% saline in 5% dextrose) at the standard maintenance rate or hypotonic fluid (0.18% saline in 5% dextrose) at two-thirds of the standard maintenance rate...
March 2, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28334502/development-of-a-dried-blood-spot-hplc-pda-method-for-the-analysis-of-linezolid-and-ciprofloxacin-in-hospital-acquired-pneumonia-patients
#18
Vincenzo Ferrone, Maura Carlucci, Roberto Cotellese, Paolo Raimondi, Annadomenica Cichella, Lorenzo Di Marco, Salvatore Genovese, Giuseppe Carlucci
This study developed a HPLC method involving dried blood spotting as sampling method for the therapeutic drug monitoring of the antimicrobial combination therapy with linezolid and ciprofloxacin. DBS for standards, quality control samples, and patient samples were excised and then extracted using a mixture of methanol/water/formic acid 80:20:0.1 (v/v/v), respectively. Linezolid (LZD) and ciprofloxacin (CPR) were measured by a high performance liquid chromatography using a Kinetex EVO C18 (100 x 4.6 mm I.D...
March 23, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28334487/growing-up-with-perinatal-human-immunodeficiency-virus-a-life-not-expected
#19
Elaine Fay Williams
AIM AND OBJECTIVES: To describe the lived experience of young adults with perinatally acquired HIV (PaHIV). BACKGROUND: The advancement of the highly active antiretroviral treatment, PaHIV-infection has transformed into a chronic lifelong illness that is faced by young adults who grew up with HIV. The known challenges that are associated with HIV are poverty, stigma and social and emotional isolation. DESIGN: This was a qualitative single interview study of a convenience sample of PaHIV-infected young adults receiving care at a large metropolitan pediatric hospital...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28333697/medication-reconciliation-during-hospitalization-and-in-hospital-home-interface-an-observational-retrospective-study
#20
Elisabetta Volpi, Alessandro Giannelli, Giulio Toccafondi, Monica Baroni, Sara Tonazzini, Stefania Alduini, Stefania Biagini, Rosa Gini, Tommaso Bellandi, Michele Emdin
OBJECTIVE: Medication errors are one of the leading causes of patient harms. Medication reconciliation is a fundamental process that to be effective, it should be embraced during each single care transition. Our objectives were to investigate current medication reconciliation practices in the 2 Fondazione Toscana Gabriele Monasterio hospitals and comprehensively assess the quality of medication reconciliation practices between inpatient and outpatient care by analyzing the medication patterns 6 months before admission, during hospitalization, and 9 months after discharge for a selected group of patients with cardiovascular diseases...
March 22, 2017: Journal of Patient Safety
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