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https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#1
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#2
Caroline P Thirukumaran, Laurent G Glance, Helena Temkin-Greener, Meredith B Rosenthal, Yue Li
BACKGROUND: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program. OBJECTIVE: To determine whether the Program was associated with changes in HAC incidence, and whether this association varies across hospitals with differential Medicare patient load...
December 5, 2016: Medical Care
https://www.readbyqxmd.com/read/27922682/gene-expression-profiles-of-cyp24a1-and-cyp27b1-in-malignant-and-normal-breast-tissues
#3
Naghmeh Zhalehjoo, Yadollah Shakiba, Mojtaba Panjehpour
Active vitamin D has several antitumor effects, including prodifferentiative, antiproliferative and proapoptotic functions in a number of tissues via its binding to vitamin D receptor. The 24‑hydroxylase (CYP24A1) and 1‑hydroxylase (CYP27B1) enzymes are considered to be pivotal determinants of the local concentration of active vitamin D. The aim of the present study was to investigate the mRNA expression levels of the CYP24A1 and CYP27B1 genes in malignant and normal breast tissues. The tumor and adjacent normal tissue samples of 30 patients with breast cancer were acquired from the Iran National Tumor Bank, Imam Hospital (Tehran, Iran)...
December 6, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27922126/viral-and-bacterial-co-infection-in-severe-pneumonia-triggers-innate-immune-responses-and-specifically-enhances-ip-10-a-translational-study
#4
Jonathan Hoffmann, Daniela Machado, Olivier Terrier, Stephane Pouzol, Mélina Messaoudi, Wilma Basualdo, Emilio E Espínola, Rosa M Guillen, Manuel Rosa-Calatrava, Valentina Picot, Thomas Bénet, Hubert Endtz, Graciela Russomando, Gláucia Paranhos-Baccalà
Mixed viral and bacterial infections are widely described in community-acquired pneumonia; however, the clinical implications of co-infection on the associated immunopathology remain poorly studied. In this study, microRNA, mRNA and cytokine/chemokine secretion profiling were investigated for human monocyte-derived macrophages infected in-vitro with Influenza virus A/H1N1 and/or Streptococcus pneumoniae. We observed that the in-vitro co-infection synergistically increased interferon-γ-induced protein-10 (CXCL10, IP-10) expression compared to the singly-infected cells conditions...
December 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27921227/-nosocomial-pneumonia-from-a%C3%A2-radiological-perspective
#5
REVIEW
P Agarwal, A Wielandner
Due to the high morbidity and mortality, nosocomial pneumonia represents a serious risk in hospitalized patients. The increased risk of infections with multidrug-resistant (MDR) pathogens makes a timely diagnosis and prompt therapy indispensable. A newly occurring or progressive infiltrate in any patient who has been hospitalized for more than 48 h should be viewed with suspicion. In contrast to community acquired pneumonia (CAP), radiography plays a limited role in the diagnosis of hospital-acquired pneumonia (HAP)...
December 5, 2016: Der Radiologe
https://www.readbyqxmd.com/read/27920678/diffuse-bullous-eruptions-in-an-elderly-woman-late-onset-bullous-systemic-lupus-erythematosus
#6
Prajwal Boddu, Mojtaba Nadiri, Owais Malik
Vesiculobullous eruptions in the elderly represent a diverse range of varying pathophysiologies and can present a significant clinical dilemma to the diagnostician. Diagnosis requires a careful review of clinical history, attention to detail on physical and histomorphological examination, and appropriate immunofluorescence testing. We describe the case of a 73-year-old female who presented to our hospital with a painful blistering skin rash developed over 2 days. Examination of the skin was remarkable for numerous flaccid hemorrhagic bullae on a normal-appearing nonerythematous skin involving both the upper and lower extremities...
September 2016: Case Reports in Dermatology
https://www.readbyqxmd.com/read/27919520/the-nanjing-glycated-hemoglobin-standardization-program-2012-to-2015
#7
Kui Zhang, Yan Wang, Hongxia Wei, Zhiye Xu
PURPOSE: This study aims to investigate glycosylated hemoglobin (HbA1c), between-laboratory imprecision (%CV), and pass rates from 2012 to 2015 in Nanjing to provide evidence for improving the HbA1c measurement. METHODS: This was a retrospective, descriptive analysis of HbA1c levels obtained from participating hospitals in Nanjing from 2012 to 2015. The HbA1c levels of fresh whole blood samples taken from healthy and diabetic adults were determined within 24 hours...
December 2, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27918888/online-continuing-interprofessional-education-on-hospital-acquired-infections-for-latin-america
#8
Julio C Medina-Presentado, Alvaro Margolis, Lucia Teixeira, L Lorier, Ana C Gales, Graciela Pérez Sartori, Maura S Oliveira, Verónica Seija, Daniela Paciel, Rafael Vignoli, Silvia Guerra, Henry Albornoz, Zaida Arteta, Antonio Lopez-Arredondo, Sofía García
INTRODUCTION: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology...
December 2, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#9
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918639/evaluation-of-an-outpatient-protocol-in-the-treatment-of-canine-parvoviral-enteritis
#10
Emilee C Venn, Karolina Preisner, Pedro L Boscan, David C Twedt, Lauren A Sullivan
OBJECTIVE: To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. INTERVENTIONS: Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission...
December 5, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27918384/twelve-years-of-kawasaki-disease-in-portugal-epidemiology-in-hospitalized-children
#11
Fátima F Pinto, Sérgio Laranjo, Miguel Mota Carmo, Maria João Brito, Rui Cruz Ferreira
BACKGROUND: Kawasaki disease (KD) became the leading cause of acquired heart disease in developed countries. Reported incidences vary worldwide, but it hasn't been established in Portugal. AIM: To describe the epidemiologic characteristics and estimate incidence rates of KD among hospitalized children in Portugal. METHODS: Descriptive, population-based study, using hospital discharge records with KD diagnosis, for patients <20 years selected from the Hospital Register database from 2000-2011...
November 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27918269/prevention-of-hospital-acquired-bloodstream-infections-through-chlorhexidine-gluconate-impregnated-washcloth-bathing-in-intensive-care-units-a-systematic-review-and-meta-analysis-of-randomised-crossover-trials
#12
Elsa Afonso, Koen Blot, Stijn Blot
We assessed the impact of 2% daily patient bathing with chlorhexidine gluconate (CHG) washcloths on the incidence of hospital-acquired (HA) and central line-associated (CLA) bloodstream infections (BSI) in intensive care units (ICUs). We searched randomised studies in Medline, EMBASE, Cochrane Library (CENTRAL) and Web of Science databases up to April 2015. Primary outcomes were total HABSI, central line, and non-central line-associated BSI rates per patient-days. Secondary outcomes included Gram-negative and Gram-positive BSI rates and adverse events...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#13
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27917374/identification-and-characterization-of-staphylococcus-aureus-strains-with-an-incomplete-hemolytic-phenotype
#14
Haifang Zhang, Yi Zheng, Huasheng Gao, Ping Xu, Min Wang, Aiqing Li, Minhui Miao, Xiaofang Xie, Yimai Deng, Huiqin Zhou, Hong Du
Staphylococcus aureus is a common pathogen causing both hospital and community-acquired infections. Hemolysin is one of the important virulence factors for S. aureus and causes the typical β-hemolytic phenotype which is called complete hemolytic phenotype as well. Recently, S. aureus with an incomplete hemolytic phenotype (SIHP) was isolated from clinical samples. To study the microbiologic characteristics of SIHP, the special hemolytic phenotype of SIHP was verified on the sheep blood agar plates supplied by different manufacturers...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27916779/delay-in-the-provision-of-medication-by-a-pharmacy-outside-the-respiratory-outpatient-department
#15
Masataka Matsumoto, Sachiko Fujita, Miwa Kannen, Kaori Kawase, Kazumi Kaneshiro, Kiyonobu Takatsuki
  Respiratory medicine physicians prescribe many different kinds of medications depending on the specific patient. To examine an outside pharmacy's ability to meet the demand of our respiratory prescription services, we developed a questionnaire for all the patients who came to our outpatient department from November 1, 2015 to January 31, 2016. A total of 298 of 330 patients answered the questionnaire.   Overall, 169 patients mainly went to the pharmacy near our hospital, whereas 64 patients mainly went to another pharmacy...
December 5, 2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/27916738/a-review-of-the-recent-advances-in-antimicrobial-coatings-for-urinary-catheters
#16
REVIEW
Priyadarshini Singha, Jason Locklin, Hitesh Handa
: More than 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 15-25% of hospitalized patients. Among other purposes, urinary catheters are primarily used for draining urine after surgeries and for urinary incontinence. During catheter-associated urinary tract infections, bacteria travel up to the bladder and cause infection. A major cause of catheter-associated urinary tract infection is attributed to the use of non-ideal materials in the fabrication of urinary catheters...
December 1, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27916621/point-should-inhaled-antibiotic-therapy-be-routinely-used-for-the-treatment-of-bacterial-lower-respiratory-tract-infections-in-the-icu-setting-yes
#17
EDITORIAL
Richard G Wunderink
Routine use of aerosolized antibiotics is the most rational approach to the current treatment dilemmas for severe hospital-acquired pneumonia (HAP) requiring endotracheal intubation or ventilator-associated pneumonia (VAP). The two main issues for HAP/VAP are inappropriate initial therapy and ineffective therapy for multidrug resistant (MDR) pathogens, particularly gram negative bacilli such as Pseudomonas aeruginosa and Acinetobacter species. The emergence of extended spectrum beta-lactamases (ESBL) and carbapenem resistance in Enterobacteriaceae (CRE) have made even common pathogens such as Escherichia coli difficult to treat...
November 22, 2016: Chest
https://www.readbyqxmd.com/read/27916571/impact-and-seasonality-of-human-rhinovirus-infection-in-hospitalized-patients-for-two-consecutive-years
#18
Jaqueline Leotte, Hygor Trombetta, Heloisa Z Faggion, Bernardo M Almeida, Meri B Nogueira, Luine R Vidal, Sonia M Raboni
OBJECTIVES: To report epidemiological features, clinical characteristics, and outcomes of human rhinovirus (HRV) infections in comparison with other community acquired respiratory virus (CRV) infections in patients hospitalized for two consecutive years. METHODS: This was a cross-sectional study. Clinical, epidemiological, and laboratory data of patients hospitalized with acute respiratory syndrome in a tertiary care hospital from 2012 to 2013 were reviewed. RESULTS: HRV was the most common CRV observed (36%, 162/444) and was present in the majority of viral co-detections (69%, 88/128), mainly in association with human enterovirus (45%)...
December 1, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27916419/comparative-transcriptomics-analyses-of-the-different-growth-states-of-multidrug-resistant-acinetobacter-baumannii
#19
Shuai Li, Haitao Li, Tianjie Qi, Xixin Yan, Boli Wang, Jitao Guan, Yu Li
Multidrug-resistant (MDR) Acinetobacter baumannii is an important bacterial pathogen commonly associated with hospital acquired infections. A. baumannii can remain viable and hence virulent in the environment for a long period of time due primarily to its ability to form biofilms. A total of 459 cases of MDR A. baumannii our hospital collected from March 2014 to March 2015 were examined in this study, and a representative isolate selected for high-throughput mRNA sequencing and comparison of gene expression profiles under the biofilm and exponential growth conditions...
December 1, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27916211/a-32-year-study-of-the-effect-of-pneumococcal-vaccines-on-invasive-streptococcus-pneumoniae-disease
#20
Ronald J Stanek, Nancy B Norton, Maurice A Mufson
BACKGROUND: Worldwide, Streptococcus pneumoniae commonly causes community-acquired pneumonia, meningitis, septicemia and otitis media. Invasive pneumococcal infection (IPD) represents the most serious presentation, occurs in approximately 1 in 4 cases and engenders case fatality rates (CFR) in pneumonia of 20-25% and meningitis of 35-40%. We investigated IPD for 32 years in an American city to assess the effect of differing pneumococcal vaccines on serotype occurrence and CFR among children and adults...
December 2016: American Journal of the Medical Sciences
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