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https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#1
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28318648/rates-of-central-line-associated-bloodstream-infection-in-tertiary-care-hospitals-in-3-arabian-gulf-countries-6-year-surveillance-study
#2
Hanan H Balkhy, Aiman El-Saed, Seif S Al-Abri, Jameela Alsalman, Huda Alansari, Zaina Al Maskari, Ayman El Gammal, Wafa Al Nasser, Amina AlJardani, Abdulhakeem Althaqafi
The objective of this study was to compare central line-associated bloodstream infection (CLABSI) rates in Gulf Cooperation Council (GCC) states with those of the U.S. National Healthcare Safety Network (NHSN) and International Nosocomial Infection Control Consortium (INICC) using pooled data from 6 hospitals in 3 GCC countries. The overall CLABSI rate was 3.1 per 1,000 central line days. After adjusting for differences in intensive care unit types, the risk of CLABSI in GCC hospitals was 146% higher than NHSN hospitals but 33% lower than INICC hospitals...
March 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28318647/prospective-evaluation-of-peripherally-inserted-central-catheter-complications-in-both-inpatient-and-outpatient-settings
#3
Christina Liscynesky, Jessica Johnston, Kelci E Haydocy, Kurt B Stevenson
We describe a prospective observational cohort (N = 187) to evaluate peripherally inserted central catheter line complications concurrently from the time of placement until removal. A significantly higher percentage of patients who experienced intraluminal thrombosis were receiving total parenteral nutrition (P ≤ .001) and had a dual lumen catheter (P = .01). Among patients with a confirmed or suspected infection, a significantly higher proportion received total parenteral nutrition (P = .01), had dual-lumen catheters (P = ...
March 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28314957/lipoteichoic-acids-from-staphylococcus-aureus-stimulate-proliferation-of-human-non-small-cell-lung-cancer-cells-in-vitro
#4
Katja Hattar, Christian P Reinert, Ulf Sibelius, Mira Y Gökyildirim, Florentine S B Subtil, Jochen Wilhelm, Bastian Eul, Gabriele Dahlem, Friedrich Grimminger, Werner Seeger, Ulrich Grandel
Pulmonary infections are frequent complications in lung cancer and may worsen its outcome and survival. Inflammatory mediators are suspected to promote tumor growth in non-small-cell lung cancer (NSCLC). Hence, bacterial pathogens may affect lung cancer growth by activation of inflammatory signalling. Against this background, we investigated the effect of purified lipoteichoic acids (LTA) of Staphylococcus aureus (S. aureus) on cellular proliferation and liberation of interleukin (IL)-8 in the NSCLC cell lines A549 and H226...
March 17, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/28301917/signaling-pathways-controlling-microglia-chemotaxis
#5
Yang Fan, Lirui Xie, Chang Y Chung
Microglia are the primary resident immune cells of the central nervous system (CNS). They are the first line of defense of the brain's innate immune response against infection, injury, and diseases. Microglia respond to extracellular signals and engulf unwanted neuronal debris by phagocytosis, thereby maintaining normal cellular homeostasis in the CNS. Pathological stimuli such as neuronal injury induce transformation and activation of resting microglia with ramified morphology into a motile amoeboid form and activated microglia chemotax toward lesion site...
March 17, 2017: Molecules and Cells
https://www.readbyqxmd.com/read/28289815/a-randomized-clinical-trial-of-ultrasound-guided-infra-clavicular-cannulation-of-the-subclavian-vein-in-cardiac-surgical-patients-short-axis-versus-long-axis-approach
#6
Antonella Vezzani, Tullio Manca, Claudia Brusasco, Gregorio Santori, Luca Cantadori, Andrea Ramelli, Gianluca Gonzi, Francesco Nicolini, Tiziano Gherli, Francesco Corradi
PURPOSE: The aim of this study was to compare the success rate and safety of short-axis versus long-axis approaches to ultrasound-guided subclavian vein cannulation. METHODS: A total of 190 patients requiring central venous cannulation following cardiac surgery were randomized to either short-axis or long-axis ultrasound-guided cannulation of the subclavian vein. Each cannulation was performed by anesthesiologists with at least 3 years' experience of ultrasound-guided central vein cannulation (>150 procedures/year, 50% short-axis and 50% long-axis)...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28289522/device-associated-infection-rates-mortality-length-of-stay-and-bacterial-resistance-in-intensive-care-units-in-ecuador-international-nosocomial-infection-control-consortium-s-findings
#7
Estuardo Salgado Yepez, Maria M Bovera, Victor D Rosenthal, Hugo A González Flores, Leonardo Pazmiño, Francisco Valencia, Nelly Alquinga, Vanessa Ramirez, Edgar Jara, Miguel Lascano, Veronica Delgado, Cristian Cevallos, Gasdali Santacruz, Cristian Pelaéz, Celso Zaruma, Diego Barahona Pinto
AIM: To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS: A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS: We followed 776 ICU patients for 4818 bed-days...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28288072/dissecting-leapfrog-how-well-do-leapfrog-safe-practices-scores-correlate-with-hospital-compare-ratings-and-penalties-and-how-much-do-they-matter
#8
Shawna N Smith, Heidi A Reichert, Jessica M Ameling, Jennifer Meddings
BACKGROUND: Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. We evaluate associations between Leapfrog SPS and Medicare measures, and the impact of SPS on HSS grades. METHODS: Using 2013 hospital data, we linked Leapfrog HSS data with central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) standardized infection ratios (SIRs), and Hospital Readmission and Hospital-Acquired Condition (HAC) Reduction Program penalties incorporating 2013 performance...
March 10, 2017: Medical Care
https://www.readbyqxmd.com/read/28283785/a-quality-improvement-initiative-to-reduce-central-line-infection-in-neonates-using-checklists
#9
Jacqueline E Taylor, Susan J McDonald, Arul Earnest, Jim Buttery, Bree Fusinato, Samantha Hovenden, Andrea Wallace, Kenneth Tan
Central line associated blood stream infections (CLABSI) are the most common complication of central catheters in neonates. These infections increase length of hospital stay, hospital costs and impact on mortality and morbidities. We performed a quasi-experimental study, over 24 months, utilising a pre-post design to determine the impact checklists had on central line infections. We introduced checklists for insertion, daily maintenance and procedural access based on the existing clinical guideline. Infections and compliance were monitored and reported back to the unit each month...
March 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28281491/status-epilepticus-refractory-and-super-refractory
#10
REVIEW
Deepanshu Dubey, Jayantee Kalita, Usha K Misra
Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent...
2017: Neurology India
https://www.readbyqxmd.com/read/28279150/icares-a-real-time-automated-detection-tool-for-clusters-of-infectious-diseases-in-the-netherlands
#11
Geert H Groeneveld, Anton Dalhuijsen, Chakib Kara-Zaïtri, Bob Hamilton, Margot W de Waal, Jaap T van Dissel, Jim E van Steenbergen
BACKGROUND: Clusters of infectious diseases are frequently detected late. Real-time, detailed information about an evolving cluster and possible associated conditions is essential for local policy makers, travelers planning to visit the area, and the local population. This is currently illustrated in the Zika virus outbreak. METHODS: In the Netherlands, ICARES (Integrated Crisis Alert and Response System) has been developed and tested on three syndromes as an automated, real-time tool for early detection of clusters of infectious diseases...
March 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28272247/high-levels-of-virological-failure-with-major-genotypic-resistance-mutations-in-hiv-1-infected-children-after-5-years-of-care-according-to-who-recommended-1st-line-and-2nd-line-antiretroviral-regimens-in-the-central-african-republic-a-cross-sectional-study
#12
Christian Diamant Mossoro-Kpinde, Jean-Chrysostome Gody, Ralph-Sydney Mboumba Bouassa, Olivia Mbitikon, Mohammad-Ali Jenabian, Leman Robin, Mathieu Matta, Kamal Zeitouni, Jean De Dieu Longo, Cecilia Costiniuk, Gérard Grésenguet, Ndèye Coumba Touré Kane, Laurent Bélec
A large cohort of 220 HIV-1-infected children (median [range] age: 12 [4-17] years) was cared and followed up in the Central African Republic, including 198 in 1st-line and 22 in 2nd-line antiretroviral regimens. Patients were monitored clinically and biologically for HIV-1 RNA load and drug resistance mutations (DRMs) genotyping. A total of 87 (40%) study children were virological responders and 133 (60%) nonresponders. In children with detectable viral load, the majority (129; 97%) represented a virological failure...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28270910/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-prevention-of-postoperative-infection-within-an-enhanced-recovery-pathway-for-elective-colorectal-surgery
#13
Stefan D Holubar, Traci Hedrick, Ruchir Gupta, John Kellum, Mark Hamilton, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Colorectal surgery (CRS) patients are an at-risk population who are particularly vulnerable to postoperative infectious complications. Infectious complications range from minor infections including simple cystitis and superficial wound infections to life-threatening situations such as lobar pneumonia or anastomotic leak with fecal peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches that can be used to reduce the risk of postoperative infections...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28267981/healthcare-associated-infections-in-cardiac-surgery-patients-with-prolonged-intensive-care-unit-stay
#14
Michael Mazzeffi, James Gammie, Bradley Taylor, Sarah Cardillo, Nicholina Haldane-Lutterodt, Anthony Amoroso, Anthony Harris, Kerri Thom
BACKGROUND: Healthcare-associated infections (HAIs) are responsible for many deaths of hospitalized patients each year. Patients with prolonged hospitalization are at high risk for HAIs. Increased efforts have been made to decrease these infections, but a recent report from the Centers for Disease Control suggests that some HAIs may be increasing. We hypothesized that HAIs would remain frequent among cardiac surgery patients with prolonged intensive care unit stay and would be associated with increased mortality...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28263245/the-treatment-of-possible-severe-infection-in-infants-an-open-randomized-safety-trial-of-parenteral-benzylpenicillin-and-gentamicin-versus-ceftriaxone-in-infants-60-days-of-age-in-malawi
#15
Elizabeth M Molyneux, Queen Dube, Francis Banda, Msandeni Chiume, Isaac Singini, Macpherson Mallewa, Edward C Schwalbe, Robert S Heyderman
BACKGROUND: The World Health Organization recommends benzylpenicillin and gentamicin as antimicrobial treatment of infants with sepsis in low income settings (LICs), and ceftriaxone or cefotaxime as an alternative. In a meta-analysis from 13 LICs, Staphylococcus aureus, Klebsiella spp. and E.coli accounted for 55% of infants with sepsis. In a review of bacterial meningitis, resistance to third generation cephalosporins was >50% of all isolates, and 44% of Gram-negative isolates were gentamicin resistant...
February 28, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28263036/comparing-the-adverse-effects-of-platinum-in-combination-with-etoposide-or-irinotecan-in-previously-untreated-small-cell-lung-cancer-patients-with-extensive-disease-a-network-meta-analyses
#16
Yujie Chen, Lingxiao Chen, Diansheng Zhong
BACKGROUND: The safety of front-line chemotherapies for the treatment of extensive stage small-cell lung cancer (ED-SCLC) is uncertain. We carried out a network meta-analysis to compare the toxicity of different therapies for ED-SCLC. METHODS: We searched EMBASE, PubMed, CENTRAL and clinicaltrials.gov. We performed network meta-analysis on hematological (anemia, leukopenia, neutropenia, and thrombocytopenia) and non-hematological toxicities (diarrhea, infection, and nausea and vomiting)...
March 6, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28260789/hbz-mediated-shift-of-jund-from-growth-suppressor-to-tumor-promoter-in-leukemic-cells-by-inhibition-of-ribosomal-protein-s25-expression
#17
M Terol, H Gazon, I Lemasson, M Duc Dodon, B Barbeau, R Césaire, J-M Mesnard, J-M Péloponèse
HTLV-1 bZIP factor (HBZ) is a key player in proliferation and transformation of HTLV-1-infected cells, thus contributing to ATL development. HBZ deregulates gene expression within the host cell by interacting with several cellular partners. Through its C-terminal ZIP domain, HBZ is able to contact and activate JunD, a transcription factor of the AP-1 family. jund mRNA is intronless but can generate two protein isoforms by alternative translation initiation: JunD full-length and ΔJunD, an N-terminal truncated form unresponsive to the tumor suppressor menin...
March 6, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#18
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28260406/reducing-preventable-harm-observations-on-minimizing-bloodstream-infections
#19
Peter J Pronovost, Sally J Weaver, Sean M Berenholtz, Lisa H Lubomski, Lisa L Maragakis, Jill A Marsteller, Julius Cuong Pham, Melinda D Sawyer, David A Thompson, Kristina Weeks, Michael A Rosen
Purpose The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings The following common interventions were implemented by hospitals able to reduce and sustain low infection rates...
March 20, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28256264/national-survey-of-practices-to-prevent-health-care-associated-infections-in-thailand-the-role-of-prevention-bundles
#20
Anucha Apisarnthanarak, David Ratz, M Todd Greene, Thana Khawcharoenporn, David J Weber, Sanjay Saint
BACKGROUND: We evaluated the practices used in Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). METHODS: From January 1, 2014-November 30, 2014, we surveyed all Thai hospitals with an intensive care unit and at least 250 beds. The use of prevention practices for CAUTI, CLABSI, and VAP was assessed. High compliance (≥75%) with all components of the CLABSI and VAP prevention bundles were determined...
February 28, 2017: American Journal of Infection Control
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