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https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#1
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28425571/clinical-factors-affecting-costs-in-patients-receiving-systemic-antifungal-therapy-in-intensive-care-units-in-greece-results-from-the-estimator-study
#2
A Armaganidis, S Nanas, E Antoniadou, K Mandragos, K Liakou, A Koutsoukou, G Baltopoulos, G Nakos, A Kounougeri, K Ganas, A Prekates, M Kompoti, D Georgopoulos, I Pneumatikos, E Zakynthinos
Invasive fungal infections are common in intensive care units (ICUs) but there is a great variability in factors affecting costs of different antifungal treatment strategies in clinical practice. To determine factors affecting treatment cost in adult ICU patients with or without documented invasive fungal infection receiving systemic antifungal therapy (SAT) we have performed a prospective, multicentre, observational study enrolling patients receiving SAT in participating ICUs in Greece. During the study period, 155 patients received SAT at 14 participating ICUs: 37 (23...
April 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28405984/a-prospective-study-of-acute-kidney-injury-according-to-kdigo-definition-and-its-mortality-predictors
#3
Rakesh Bhadade, Rosemarie De'Souza, Minal J Harde, Kalpana S Mehta, Prabhat Bhargava
BACKGROUND: Acute kidney injury is no longer considered to be an innocent bystander merely reflecting co-existent pathologies but an independent risk factor for mortality in the ICU. AIMS AND OBJECTIVES: To study clinical profile and correlation of patients with acute kidney injury (AKI) according to KDIGO definition with respect to incidence, outcome and different causes of AKI in critical care unit. STUDY DESIGN AND SETTING: It is a prospective observational study; and was carried out in the ICU of a tertiary care, teaching, public hospital...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28399851/babesiosis-in-long-island-review-of-62-cases-focusing-on-treatment-with-azithromycin-and-atovaquone
#4
Ekaterina A Kletsova, Eric D Spitzer, Bettina C Fries, Luis A Marcos
BACKGROUND: Babesiosis is a potentially life-threatening, tick-borne infection endemic in New York. The purpose of this study was to review recent trends in babesiosis management and outcomes focusing on patients, who were treated with combination of azithromycin and atovaquone. METHODS: A retrospective chart review of patients seen at Stony Brook University Hospital between 2008 and 2014 with peripheral blood smears positive for Babesia was performed. Clinical and epidemiological information was recorded and analyzed...
April 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28396650/new-onset-refractory-status-epilepticus-with-claustrum-damage-definition-of-the-clinical-and-neuroimaging-features
#5
Stefano Meletti, Giada Giovannini, Giuseppe d'Orsi, Lisa Toran, Giulia Monti, Rahul Guha, Andreas Kiryttopoulos, Maria Grazia Pascarella, Tommaso Martino, Haris Alexopoulos, Martha Spilioti, Jana Slonkova
New-onset refractory status epilepticus (NORSE) is a rare but challenging condition occurring in a previously healthy patient, often with no identifiable cause. We describe the electro-clinical features and outcomes in a group of patients with NORSE who all demonstrated a typical magnetic resonance imaging (MRI) sign characterized by bilateral lesions of the claustrum. The group includes 31 patients (12 personal and 19 previously published cases; 17 females; mean age of 25 years). Fever preceded status epilepticus (SE) in 28 patients, by a mean of 6 days...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28390959/fever-after-peripheral-blood-stem-cell-infusion-in-haploidentical-transplantation-with-post-transplant-cyclophosphamide
#6
Marcos Arango, Juan F Combariza
OBJECTIVE/BACKGROUND: Noninfection-related fever can occur after peripheral blood stem cell infusion in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide. The objective of this study was to analyze the incidence of fever and characterize some clinical features of affected patients. METHODS: A retrospective case-series study with 40 patients who received haploidentical hematopoietic stem cell transplantation was carried out...
April 3, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28361596/a-case-of-fatal-agranulocytosis-that-developed-in-a-patient-with-%C3%AE-thalassemia-major-treated-with-deferiprone
#7
Maria Mainou, Aggeliki Kotsiafti, Philippos Klonizakis, Vasiliki Soulountsi, Chrysoula Apostolou, Kiriakos Psarras, Efthymia Vlachaki
A 29-year-old male with transfusion-dependent β-thalassemia major (β-TM), splenectomized and on chelation therapy with deferiprone (DFP or L1) due to heart and liver hemosiderosis, presented with high fever and agranulocytosis. Deferiprone was discontinued and a broad spectrum antibiotic therapy was started intravenously. The patient remained febrile and showed no recovery of neutrophil count even after the initiation of granulocyte colony-stimulation factor (G-CSF). After 12 days at the hospital, he developed respiratory failure and was transferred to the intensive care unit (ICU) where he developed multi-organ failure and died 3 days later...
November 2016: Hemoglobin
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#8
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#9
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28249615/secondary-hemophagocytic-lymphohistiocytosis-in-the-setting-of-metastatic-renal-cell-carcinoma-a-case-report
#10
Monica El-Masry, Lauren Eisenbud, Minh-Ha Tran
BACKGROUND: Hemophagocytic lymphohistiocytosis is a disease process characterized by unregulated hyperactivation of the immune system associated with multiorgan involvement and high mortality rates. Early recognition is crucial and a recently validated diagnostic schema, the H-Score, may facilitate diagnosis particularly in secondary hemophagocytic lymphohistiocytosis cases. We present a patient with secondary hemophagocytic lymphohistiocytosis in association with metastatic renal cell carcinoma in whom high-dose steroid therapy induced a remarkable response...
March 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28218011/asymmetric-dimethylarginine-in-the-assessment-of-febrile-neutropenia-in-hematological-patients
#11
Marika Lappalainen, Sari Hämäläinen, Auni Juutilainen, Irma Koivula, Kari Pulkki, Esa Jantunen
Asymmetric dimethylarginine (ADMA) has been recognized as an independent prognostic factor for sepsis mortality in intensive care units. No data are available on kinetics or prognostic value of ADMA in hematological patients. We evaluated the ability of ADMA to act as a predictor for complicated course of febrile neutropenia, defined as bacteremia and/or septic shock in adult hematological patients receiving intensive chemotherapy. This prospective study included 87 adult hematological patients with febrile neutropenia after an intensive chemotherapy for acute myeloid leukemia (AML) or after an autologous stem cell transplantation (ASCT)...
April 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28217817/a-high-pct-level-correlates-with-disease-severity-in-plasmodium-falciparum-malaria-in-children
#12
Novella Carannante, Marco Rossi, Fiorentino Fraganza, Grazia Coppola, Daniela Chiesa, Vittorio Attanasio, Francesco Sbrana, Antonio Corcione, Carlo Tascini
Most clinicians in developed countries have limited experience in making clinical assessments of malaria disease severity and/or monitoring high-level parasitemia in febrile patients with imported malaria. Hyperparasitemia is a risk factor for severe P. falciparum malaria, and procalcitonin (PCT) has recently been related to the severity of malaria. In developed countries, where not all hospital have skilled personnel to count parasitemia, a rapid test might be useful for the prompt diagnosis of malaria but unfortunately these tests are not able to count the number of parasites...
January 2017: New Microbiologica
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#13
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28215136/protocol-and-statistical-analysis-plan-for-the-randomised-evaluation-of-active-control-of-temperature-versus-ordinary-temperature-management-reactor-trial
#14
Paul J Young, Michael J Bailey, Richard W Beasley, Ross C Freebairn, Naomi E Hammond, Frank M P van Haren, Meg L Harward, Seton J Henderson, Diane M Mackle, Colin J McArthur, Shay P McGuinness, John A Myburgh, Manoj K Saxena, Anne Turner, Steve A R Webb, Rinaldo Bellomo
BACKGROUND: Body temperature can be reduced in febrile patients in the intensive care unit using medicines and physical cooling devices, but it is not known whether systematically preventing and treating fever reduces body temperature compared with standard care. OBJECTIVE: To describe the study protocol and statistical analysis plan for the Randomised Evaluation of Active Control of Temperature versus Ordinary Temperature Management (REACTOR) trial. DESIGN, SETTING AND PARTICIPANTS: Protocol for a phase II, multicentre trial to be conducted in Australian and New Zealand ICUs admitting adult patients...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28174559/zika-virus-chikungunya-virus-and-dengue-virus-in-cerebrospinal-fluid-from-adults-with-neurological-manifestations-guayaquil-ecuador
#15
Nathalie Acevedo, Jesse Waggoner, Michelle Rodriguez, Lissette Rivera, José Landivar, Benjamin Pinsky, Hector Zambrano
Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) have been associated with clinical presentations that involve acute neurological complaints. In the current study, we identified ZIKV, CHIKV, and DENV in cerebrospinal fluid (CSF) samples from patients admitted to the Hospital Luis Vernaza (Guayaquil, Ecuador) to the Emergency Room or the Intensive Care Unit, with neurological symptoms and/or concern for acute arboviral infections. Viral RNA from one or more virus was detected in 12/16 patients...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#16
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#17
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28103590/risk-factors-for-intrapartum-fever-in-term-gestations-and-associated-maternal-and-neonatal-sequelae
#18
Angela P H Burgess, Justin E Katz, Michael Moretti, Nisha Lakhi
AIM: To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes. METHODS: Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant. RESULTS: Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria...
January 20, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28077045/association-of-time-to-antibiotics-and-clinical-outcomes-in-adult-hematologic-malignancy-patients-with-febrile-neutropenia
#19
Allison R Butts, Christina Carracedo Bachmeier, Emily V Dressler, Meng Liu, Ann Cowden, Jeff Talbert, Val R Adams
Objective The objective of this study was to determine the clinical impact of time to antibiotic administration in adult inpatients who have hematologic malignancies and develop febrile neutropenia. Methods A retrospective chart review was conducted to screen for all febrile neutropenia events amongst adult hematologic malignancy patients between 1 January 2010 and 1 September 2014. All included patients were admitted to the hospital at the time of fever onset, having been admitted for a diagnosis other than febrile neutropenia...
June 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28062972/predictive-performance-of-the-quick-sequential-organ-failure-assessment-score-as-a-screening-tool-for-sepsis-mortality-and-intensive-care-unit-admission-in-patients-with-febrile-neutropenia
#20
Minsoo Kim, Shin Ahn, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Kyung Soo Lim
PURPOSE: In Sepsis-3, the quick Sequential Organ Failure Assessment (qSOFA) score was developed as criteria to use for recognizing patients who may have poor outcomes. This study was performed to evaluate the predictive performance of the qSOFA score as a screening tool for sepsis, mortality, and intensive care unit (ICU) admission in patients with febrile neutropenia (FN). We also tried to compare its performance with that of the systemic inflammatory response syndrome (SIRS) criteria and Multinational Association of Supportive Care in Cancer (MASCC) score for FN...
May 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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