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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29166368/public-health-economic-burden-associated-with-two-single-measles-case-investigations-colorado-2016-2017
#2
Grace E Marx, Jennifer Chase, Joseph Jasperse, Kaylan Stinson, Carol E McDonald, Janine K Runfola, Jillian Jaskunas, Donna Hite, Meghan Barnes, Michele Askenazi, Bernadette Albanese
During July 2016-January 2017, two unrelated measles cases were identified in the Denver, Colorado area after patients traveled to countries with endemic measles transmission. Each case resulted in multiple exposures at health care facilities and public venues, and activated an immediate and complex response by local and state public health agencies, with activities led by the Tri-County Health Department (TCHD), which serves Adams, Arapahoe, and Douglas counties. To track the economic burden associated with investigating and responding to single measles cases, personnel hours and supply costs incurred during each investigation were tracked prospectively...
November 24, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29166342/important-considerations-for-performing-prepectoral-breast-reconstruction
#3
Hani Sbitany
Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction. Safely performed prepectoral breast reconstruction requires a careful patient selection process before committing to the procedure, taking into account comorbidities, radiation status, and oncologic criteria such as tumor location and breast cancer stage...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166257/raoultella-planticola-a-rare-cause-of-wound-infection
#4
Shana S Kalaria, Kristina Elliott, Neal Combs, Linda G Phillips
Raoultella planticola is a gram-negative, aerobic, rod bacterium commonly found in the environment, particularly in water, soil, and fish. This organism has been found to cause a variety of infections, such as necrotizing fasciitis, cystitis, cholecystitis, pancreatitis, hepatic disease, and soft tissue infections. The authors report the case of a 73-year-old-woman who presented with a R planticola wound infection of her left lower extremity after a dog scratch. She was treated successfully with local wound care using dehydrated human amnion/chorion and oral levofloxacin...
November 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29165600/missed-opportunities-to-identify-occupational-asthma-in-acute-secondary-care
#5
P R Ellis, G I Walters
Background: Occupational asthma (OA) accounts for one in six cases of new-onset adult asthma. Despite this it remains under-recognized in the UK. Delayed and missed diagnoses of OA lead to poor health outcomes for workers at significant cost to the UK economy. The burden of occupational aetiology on hospital admissions with asthma is not known. Aims: To measure how frequently medical professionals consider occupational aetiology in patients presenting to secondary care with acute asthma symptoms...
November 18, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/29164170/impact-of-procalcitonin-guided-antibiotic-management-on-antibiotic-exposure-and-outcomes-real-world-evidence
#6
Michael R Broyles
Background: Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is useful for antibiotic management. The objective of our study was to evaluate the impact of a PCT algorithm (PCT-A) on current practice. Methods: A single-center, retrospective cohort study was conducted to evaluate the impact of adding PCT-A to stewardship practices...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29164119/spontaneous-reversion-of-clinical-conditions-measuring-the-risk-profile-of-the-individual-from-frailty-to-mild-cognitive-impairment
#7
REVIEW
Marco Canevelli, Giuseppe Bruno, Francesca Remiddi, Carlo Vico, Eleonora Lacorte, Nicola Vanacore, Matteo Cesari
The number of people living with disabilities worldwide is rapidly growing due to a longer life expectancy and the subsequent increasing burden of chronic diseases. The need of developing and implementing effective strategies aimed at delaying or preventing disability has been repeatedly underlined and is currently the main focus of several health-care policies. In this scenario, a special attention is addressed to the identification of specific clinical conditions measuring the risk profile of the individual of developing an overt disability and other negative outcomes...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29163979/use-of-a-social-media-network-to-reduce-early-neonatal-mortality-a-preliminary-report-from-a-quality-improvement-project-in-yaound%C3%A3-cameroon
#8
Adidja Amani, Jobert Richie Nansseu, Evelyn M Mah, Clemence Meguejio Vougmo, Seidou Moluh Moluh, Robinson Mbu
Background: Perinatal networks have yielded substantial contribution in decreasing the neonatal mortality rate. We present here the process of implementation of a perinatal network in Yaoundé (Cameroon) based on the WhatsApp messenger application as well as some preliminary results and achievements. Methods: In December 2016, the Yaoundé Perinatal Network was launched, regrouping a multidisciplinary team of health professionals dealing with perinatal care in Yaoundé, Cameroon...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29163332/clinical-use-of-cerebral-microdialysis-in-patients-with-aneurysmal-subarachnoid-hemorrhage-state-of-the-art
#9
REVIEW
Raimund Helbok, Mario Kofler, Alois Josef Schiefecker, Maxime Gaasch, Verena Rass, Bettina Pfausler, Ronny Beer, Erich Schmutzhard
Objective: To review the published literature on the clinical application of cerebral microdialysis (CMD) in aneurysmal subarachnoid hemorrhage (SAH) patients and to summarize the evidence relating cerebral metabolism to pathophysiology, secondary brain injury, and outcome. Methods: Study selection: Two reviewers identified all manuscripts reporting on the clinical use of CMD in aneurysmal SAH patients from MEDLINE. All identified studies were grouped according to their focus on brain metabolic changes during the early and subacute phase after SAH, their association with mechanisms of secondary brain injury and outcome...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29162651/transoceanic-management-and-treatment-of-aneurysmal-subarachnoid-hemorrhage-a-10-year-experience
#10
Mehdi Mejdoubi, Mathieu Schertz, Sylvia Zanolla, Hossein Mehdaoui, Michel Piotin
BACKGROUND AND PURPOSE: Because of the small number of yearly cases of ruptured cerebral aneurysms, endovascular treatment is not performed in Martinique. Therefore, patients from Martinique are sent 7000 km to Paris on commercial flights as soon as possible, where treatment is performed. Nontransportable patients are treated locally with either surgery or symptomatic care. The objective of our study was to assess patient outcomes and safety of this treatment strategy. METHODS: We retrospectively examined all cases of aneurysmal subarachnoid hemorrhage in Martinique diagnosed during 2004 to 2013...
November 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29162633/use-of-prostaglandins-in-duct-dependent-congenital-heart-conditions
#11
REVIEW
Yogen Singh, Paraskevi Mikrou
Congenital heart disease (CHD) remains a leading cause of infant mortality, which is even higher in infants with undiagnosed duct-dependent CHDs. Up to 39%-50% of infants with critical CHD are being discharged undiagnosed from the hospital. Infants with duct-dependent critical CHD remain well during the fetal period and may deteriorate when the ductus arteriosus (commonly called 'duct') closes after birth. It is critical to open or maintain ductus arteriosus patent in infants with duct-dependent CHDs. Prostaglandin E1 (alprostadil marketed as 'Prostin VR ') and prostaglandin E2 (dinoprostone) are used to maintain a patent ductus arteriosus and the dose of medication depends on the clinical presentation...
November 21, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29162468/an-assessment-of-rehabilitation-infrastructure-in-peru
#12
Amy K Fuhs, Lacey N LaGrone, Miguel G Moscoso Porras, Manuel J A Rodríguez Castro, Rosa Lizbeth Ecos Quispe, Charles N Mock
OBJECTIVE: To assess rehabilitation infrastructure in Peru in terms of WHO Health System Building Blocks. DESIGN: Anonymous quantitative survey. Questions were based on WHO Guidelines for Essential Trauma Care and rehabilitation professionals' input. SETTING: Nine large public hospitals and referral centers in Lima and an online survey platform. PARTICIPANTS: Convenience sample of hospital personnel working in rehabilitation and neurology, recruited through existing contacts and professional societies...
November 18, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#13
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29162067/necrotizing-fasciitis-after-high-dose-rate-brachytherapy-and-external-beam-radiation-for-prostate-cancer-a-case-report
#14
Shimpei Yamashita, Yasuo Kohjimoto, Akinori Iba, Kazuro Kikkawa, Isao Hara
BACKGROUND: In recent years, the delayed side effects associated with radiotherapy for prostate cancer have drawn the interest of urologists. Although urosymphyseal fistula is one of these delayed side effects, this serious complication is rarely described in literature and is poorly recognized. CASE PRESENTATION: We report our experience in treating a 77-year-old male patient with necrotizing fasciitis after high-dose rate brachytherapy plus external beam radiation for prostate cancer...
November 21, 2017: BMC Urology
https://www.readbyqxmd.com/read/29162057/translating-a-child-care-based-intervention-for-online-delivery-development-and-randomized-pilot-study-of-go-napsacc
#15
Dianne S Ward, Amber E Vaughn, Stephanie Mazzucca, Regan Burney
BACKGROUND: As part of childhood obesity prevention initiatives, Early Care and Education (ECE) programs are being asked to implement evidence-based strategies that promote healthier eating and physical activity habits in children. Translation of evidence-based interventions into real world ECE settings often encounter barriers, including time constraints, lack of easy-to-use tools, and inflexible intervention content. This study describes translation of an evidence-based program (NAPSACC) into an online format (Go NAPSACC) and a randomized pilot study evaluating its impact on centers' nutrition environments...
November 21, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29162041/does-anthracycline-based-chemotherapy-in-pregnant-women-with-cancer-offer-safe-cardiac-and-neurodevelopmental-outcomes-for-the-developing-fetus
#16
Marialuisa Framarino-Dei-Malatesta, Paolo Sammartino, Angela Napoli
BACKGROUND: Cancer treatment during pregnancy is a growing problem especially now that women delay childbearing. Systemic treatment of these malignancies during pregnancy centers mainly on the anticancer drugs anthracyclines, widely used in treating hematological and breast cancer during pregnancy and sometimes associated with early and late toxicity for the fetus. Owing to concern about their cardiac and neurodevelopmental toxicity more information is needed on which anthracycline to prefer and whether they can safely guarantee a cardiotoxicity-free outcome in the fetus...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29161979/clinical-characteristics-of-intravenous-peg-asparaginase-hypersensitivity-reactions-in-patients-undergoing-treatment-for-acute-lymphoblastic-leukemia
#17
Emily K Browne, Christina Moore, April Sykes, Zhaohua Lu, Sima Jeha, Belinda N Mandrell
BACKGROUND: Asparaginase poses a substantial risk for hypersensitivity reactions during and after administration; however, these reactions vary by asparaginase formulation and administration route. It is imperative that nurses be knowledgeable of clinical symptoms associated with intravenous (IV) monomethoxypolyethylene glycol (PEG)-asparaginase reactions, as well as potential reaction timing. PURPOSE: This single institution retrospective study describes the clinical factors among patients with IV PEG-asparaginase hypersensitivity reactions...
November 1, 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/29161116/corticosteroid-therapy-for-critically-ill-patients-with-the-middle-east-respiratory-syndrome
#18
Yaseen M Arabi, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Ghaleb A Al Mekhlafi, Mohamed A Hussein, Jesna Jose, Ruxandra Pinto, Awad Al-Omari, Ayman Kharaba, Abdullah Almotairi, Kasim Al Khatib, Basem Alraddadi, Sarah Shalhoub, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Hanan H Balkhy, Abdulrahman Al Harthy, Ahmad M Deeb, Hanan Al Mutairi, Abdulaziz Al-Dawood, Laura Merson, Frederick G Hayden, Robert A Fowler
RATIONALE: Corticosteroid therapy is commonly used among critically ill patients with the Middle East Respiratory Syndrome (MERS), but its impact on outcomes is uncertain. Analyses of observational studies often do not account for patients' clinical condition at the time of corticosteroid therapy initiation. OBJECTIVES: To investigate the association of corticosteroid therapy on mortality and on MERS coronavirus RNA clearance in critically ill patients with MERS...
November 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29160213/cutaneous-metastases-of-internal-malignancies-an-experience-from-a-single-institution
#19
Elena Guanziroli, Antonella Coggi, Luigia Venegoni, Daniele Fanoni, Giulia Ercoli, Francesca Boggio, Stefano Veraldi, Emilio Berti, Raffaele Gianotti, Stefano Ferrero, Alessandro Del Gobbo
BACKGROUND: Cutaneous metastases represent 2% of all skin tumours. Their recognition can be challenging, as they may present with different clinical features, with consequent frequent delay and failure in diagnosis. OBJECTIVES: To review our series of cutaneous metastatic lesions, analyse their frequency according to patient gender, histotype, localization of the primary tumour, and site of cutaneous metastasis, and correlate this data with clinicopathological parameters...
November 21, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/29158922/hypoxemic-respiratory-failure-from-acute-respiratory-distress-syndrome-secondary-to-leptospirosis
#20
Shannon M Fernando, Pierre Cardinal, Peter G Brindley
Acute respiratory distress syndrome (ARDS), characterized by hypoxemic respiratory failure, is associated with a mortality of 30-50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU) admission. The most common precipitant is community-acquired bacterial pneumonia, but other putative pathogens include viruses and fungi. On rare occasions, ARDS can be secondary to tropical disease...
2017: Case Reports in Critical Care
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