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https://www.readbyqxmd.com/read/29452598/7-versus-14-days-of-antibiotic-treatment-for-critically-ill-patients-with-bloodstream-infection-a-pilot-randomized-clinical-trial
#1
Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Pierre Aslanian, Sean M Bagshaw, Alex Carignan, Emmanuel Charbonney, Bryan Coburn, Deborah J Cook, Michael E Detsky, Peter Dodek, Richard Hall, Anand Kumar, Francois Lamontagne, Francois Lauzier, John C Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Wendy Sligl, Henry T Stelfox, M Elizabeth Wilcox, Robert A Fowler
BACKGROUND: Shorter-duration antibiotic treatment is sufficient for a range of bacterial infections, but has not been adequately studied for bloodstream infections. Our systematic review, survey, and observational study indicated equipoise for a trial of 7 versus 14 days of antibiotic treatment for bloodstream infections; a pilot randomized clinical trial (RCT) was a necessary next step to assess feasibility of a larger trial. METHODS: We conducted an open, pilot RCT of antibiotic treatment duration among critically ill patients with bloodstream infection across 11 intensive care units (ICUs)...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29451168/percutaneous-catheter-drainage-followed-by-endoscopic-transluminal-drainage-necrosectomy-for-treatment-of-infected-pancreatic-necrosis-in-early-phase-of-illness
#2
Surinder Singh Rana, Rajesh Gupta, Mandeep Kang, Vishal Sharma, Ravi Sharma, Ujjwal Gorsi, Deepak K Bhasin
Background and Objectives: Infected pancreatic necrosis (IPN) in the early phase is treated with "step up approach" involving initial percutaneous catheter drainage (PCD) followed by necrosectomy. There is a paucity of data on a combined approach of initial PCD followed by endoscopic drainage and necrosectomy. A retrospectively study on safety and efficacy of initial PCD followed by endoscopic transluminal drainage and necrosectomy in IPN. Methods: Retrospective analysis of data of 23 patients with IPN who were treated with a combined approach...
January 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29447988/escmid-study-group-for-infections-in-compromised-hosts-esgich-consensus-document-on-the-safety-of-targeted-and-biological-therapies-an-infectious-diseases-perspective-agents-targeting-lymphoid-cells-surface-antigens-i-cd19-cd20-and-cd52
#3
REVIEW
Małgorzata Mikulska, Simone Lanini, Carlota Gudiol, Lubos Drgona, Giuseppe Ippolito, Mario Fernández-Ruiz, Bernd Salzberger
BACKGROUND: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. AIMS: To review, from an Infectious Diseases perspective, the safety profile of agents targeting CD19, CD20 and CD52 and to suggest preventive recommendations. SOURCES: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family...
February 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#4
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29446842/epidemiology-and-risk-factors-for-outpatient-acquired-catheter-related-bloodstream-infections-in-children-receiving-home-parenteral-nutrition
#5
Laura J Wozniak, Hannah M Bechtold, Laurie E Reyen, Alvin P Chan, Elizabeth A Marcus, Jorge H Vargas
BACKGROUND: Few studies have examined the epidemiology and risk factors for the development of outpatient-acquired catheter-related bloodstream infections (CRBSIs) in children receiving home parenteral nutrition. This study aimed to (1) characterize the incidence, clinical presentation, and epidemiology of CRBSIs and (2) identify risk factors for CRBSIs in children receiving home parenteral nutrition. METHODS: A longitudinal database approved by our Institutional Review Board was created to prospectively track CRBSIs in the UCLA pediatric population from January to December 2012...
February 15, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29445984/impact-of-antibiotic-prophylaxis-on-catheter-associated-urinary-tract-infections-during-atrial-fibrillation-ablation
#6
David E Lewandowski, David Pierce, Anne Barnett, Emmanuel Sampene, Nasia Safdar, Michael E Field, Jennifer M Wright
PURPOSE: Urinary catheter placement is common during atrial fibrillation (AF) ablation when performed under general anesthesia. Whether patients undergoing AF ablation would benefit from prophylactic antibiotics is unknown. METHODS: Patients undergoing AF ablation in a single center from December 2011 until June 2016 were included. All patients received urinary catheters and general anesthesia. After June 2014, patients received antibiotic prophylaxis with a single dose of oral nitrofurantoin and a catheter insertion checklist performed prior to urinary catheter placement...
February 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29444733/medically-attended-catheter-complications-are-common-in-patients-with-outpatient-central-venous-catheters
#7
Steven S Spires, Peter F Rebeiro, Mickie Miller, Katie Koss, Patty W Wright, Thomas R Talbot
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services...
February 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29443850/does-an-algorithmic-approach-to-using-brachytherapy-and-external-beam-radiation-result-in-good-function-local-control-rates-and-low-morbidity-in-patients-with-extremity-soft-tissue-sarcoma
#8
Jason Klein, Alex Ghasem, Samuel Huntley, Nathan Donaldson, Martin Keisch, Sheila Conway
BACKGROUND: High-dose-rate brachytherapy (HDR-BT) and external-beam radiation therapy (EBRT) are two modalities used in the treatment of soft tissue sarcoma. Previous work at our institution showed early complications and outcomes for patients treated with HDR-BT, EBRT, or a combination of both radiation therapy modalities. As the general indications for each of these approaches to radiation therapy differ, it is important to evaluate the use of each in an algorithmic way, reflecting how they are used in contemporary practice at sites that use these treatments...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29443508/development-of-an-infection-responsive-fluorescent-sensor-for-the-early-detection-of-urinary-catheter-blockage
#9
Scarlet Milo, Florianne B Acosta, Hollie J Hathaway, Laura A Wallace, Naing T Thet, A Toby A Jenkins
Formation of crystalline biofilms following infection by Proteus mirabilis can lead to encrustation and blockage of long-term indwelling catheters, with serious clinical consequences. We describe a simple sensor, placed within the catheter drainage bag, to alert of impending blockage via a urinary color change. The pH-responsive sensor is a dual-layered polymeric "lozenge", able to release the self-quenching dye 5(6)-carboxyfluorescein in response to the alkaline urine generated by the expression of bacterial urease...
February 14, 2018: ACS Sensors
https://www.readbyqxmd.com/read/29443407/implanted-vascular-access-device-options-a-focused-review-on-safety-and-outcomes
#10
REVIEW
Merilda O Blanco-Guzman
Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29443395/subcutaneous-infusion-of-fluids-for-hydration-or-nutrition-a-review
#11
REVIEW
Riccardo Caccialanza, Thierry Constans, Paolo Cotogni, Gary P Zaloga, Alessandro Pontes-Arruda
Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29443394/catheter-related-bloodstream-infections-in-adults-receiving-home-parenteral-nutrition-substantial-differences-in-incidence-comparing-a-strict-microbiological-to-a-clinically-based-diagnosis
#12
Siri Tribler, Christopher F Brandt, Mark Hvistendahl, Michael Staun, Per Brøbech, Claus E Moser, Palle B Jeppesen
BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI definitions affects the reported incidence. MATERIALS AND METHODS: In an observational study based on the Copenhagen intestinal failure database, all clinically reported CRBSIs from 2002-2013 were compared with data from the affiliated microbiological database according to recommended CRBSI criteria...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29437771/hepatotoxicity-associated-with-vismodegib
#13
Prabhjot S Bedi, Manoj P Rai, Nishant Tageja, Heather Laird-Fick
An 82-year-old Caucasian woman with a history of basal cell carcinoma on vismodegib presented with nausea, vomiting and intermittent abdominal pain. Laboratory results were remarkable for the elevation of liver enzymes. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiogram (PTC) did not show evidence of intrahepatic or extrahepatic obstruction of the biliary tract. During PTC external biliary catheter was placed; however, bilirubin continued to rise. Further, laboratory work-up and imaging studies ruled out other possible aetiologies for hepatotoxicity such as infections, autoimmune hepatitis and other drugs known to be hepatotoxic thus leaving vismodegib the most likely cause of hepatotoxicity...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29437141/laparoscopic-omentopexy-rectus-sheath-tunneling-and-implantation-of-the-peritoneal-dialysis-catheter-using-a-peritoneal-dialysis-port
#14
Mohammad Reza Keramati, Ali Abbaszadeh-Kasbi, Amir Keshvari
BACKGROUND: Prophylactic laparoscopic omentopexy is a safe technique to prevent peritoneal dialysis (PD) catheter obstruction. For the first time, we would like to describe a surgical technique in which the omentopexy is done using a single PD port which is used for the omentopexy, PD catheter insertion, and the rectus sheath tunneling of the catheter. METHODS: The surgical method of the omentopexy using the PD port (US Patent 20170119430) will be thoroughly described...
February 7, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29437082/prevention-of-catheter-associated-urinary-tract-infections-in-adults
#15
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29437076/transcatheter-pulmonary-valve-replacement-in-patients-with-congenital-heart-disease
#16
Shantelle Bartra
Transcatheter pulmonary valve replacement is now a feasible alternative to surgical pulmonary valve replacement in children and adults with dysfunctional right ventricular outflow conduits. Currently, 2 types of valves can be used for this application. This article provides an overview of the procedure and how it is performed, indications and contraindications for transcatheter pulmonary valve replacement, and short- and long-term outcomes. Nursing considerations mainly focus on educating patients, preventing bleeding and infection, monitoring renal function, and preventing injury to the catheter insertion site...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29432818/differential-time-to-positivity-of-central-and-peripheral-blood-cultures-is-inaccurate-for-the-diagnosis-of-staphylococcus-aureus-long-term-catheter-related-sepsis
#17
Hanène Bouzidi, Aurélie Emirian, Antoine Marty, Elisabeth Chachaty, Agnès Laplanche, Bertrand Gachot, François Blot
OBJECTIVES: Differential time to positivity of cultures of blood drawn simultaneously from central venous catheter and peripheral sites is widely used to diagnose catheter-related bloodstream infections without removing the catheter. However, the accuracy of this technique for some pathogens such as Staphylococcus aureus is debated in routine practice. METHODS: In a 320-bed reference cancer centre, we retrospectively studied the charts of patients with at least one blood culture positive for S...
February 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29428697/transient-bacteremia-induced-by-dental-cleaning-is-not-associated-with-infection-of-central-venous-catheters-in-patients-with-cancer
#18
Saad Usmani, Linda Choquette, Robert Bona, Richard Feinn, Zainab Shahid, Rajesh V Lalla
OBJECTIVE: The aim of this study was to determine the incidence of bacteremia resulting from dental cleaning and of subsequent established bloodstream infection (BSI) caused by oral microorganisms in patients with cancer with central venous catheters (CVCs). STUDY DESIGN: Twenty-six patients with cancer with CVCs and absolute neutrophil count over 1000 cells/µL received dental cleaning without antibiotic prophylaxis. Periodontal status was assessed at baseline by using the Periodontal Screening and Recording (PSR) score...
January 11, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29427820/techniques-for-successful-early-retrieval-of-the-micra-transcatheter-pacing-system-a-worldwide-experience
#19
Muhammad R Afzal, Emile G Daoud, Ryan Cunnane, Shiva K Mulpuru, Alan Koay, Azlan Hussain, Razali Omar, Koh Kok Wei, Anish Amin, Gregory Kidwell, Nirav Patel, Charles Love, Michel Llyod, Maciej Sterliński, Seth Goldbarg, Miguel A Leal, James Gabriels, Apoor Patel, Ram Jadonath, Eric Grubman, George Crossley, Chris Pepper, Dhanunjaya Lakkireddy, Toshimasa Okabe, John D Hummel, Ralph S Augostini
BACKGROUND: Due to relatively newer technology, experience with retrieval of Micra transcatheter pacing system (TPS) is limited. Although, it is recommended to abandon the TPS at end of life, certain situations such as endovascular infections or device embolization warrant retrieval. OBJECTIVES: To report worldwide experience of successful retrieval for Micra TPS. METHODS: The list of all successful retrievals for the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS...
February 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29426705/is-a-project-needed-to-prevent-urinary-tract-infection-in-patients-admitted-to-spanish-icus
#20
F Álvarez Lerma, P Olaechea Astigarraga, X Nuvials, R Gimeno, M Catalán, M P Gracia Arnillas, I Seijas Betolaza, M Palomar Martínez
OBJECTIVE: To analyze epidemiological data of catheter-associated urinary tract infection (CAUTI) in critically ill patients admitted to Spanish ICUs in order to assess the need of implementing a nationwide intervention program to reduce these infections. DESIGN: Non-intervention retrospective annual period prevalence analysis. SETTING: Participating ICUs in the ENVIN-UCI multicenter registry between the years 2007-2016. PATIENTS: Critically ill patients admitted to the ICU with catheter-associated urinary tract infection (CAUTI)...
February 6, 2018: Medicina Intensiva
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