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https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#1
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28320186/neurological-complications-after-tuberculous-meningitis-in-a-multi-state-cohort-in-the-united-states
#2
Alexander E Merkler, Alexandra S Reynolds, Gino Gialdini, Nicholas A Morris, Santosh B Murthy, Kiran Thakur, Hooman Kamel
BACKGROUND AND PURPOSE: To assess the rate of neurological complications and mortality after tuberculous meningitis in the United States. METHODS: The authors performed a retrospective cohort study of all patients 18years or older hospitalized for tuberculous meningitis in California between 2005 and 2010, New York between 2006 and 2012, and Florida between 2005 and 2012. Outcomes of interest were mortality and the following neurological complications: stroke, seizure, hydrocephalus requiring a ventriculoperitoneal shunt, vision impairment, and hearing impairment...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319229/patient-mortality-during-unannounced-accreditation-surveys-at-us-hospitals
#3
Michael L Barnett, Andrew R Olenski, Anupam B Jena
Importance: In the United States, hospitals receive accreditation through unannounced on-site inspections (ie, surveys) by The Joint Commission (TJC), which are high-pressure periods to demonstrate compliance with best practices. No research has addressed whether the potential changes in behavior and heightened vigilance during a TJC survey are associated with changes in patient outcomes. Objective: To assess whether heightened vigilance during survey weeks is associated with improved patient outcomes compared with nonsurvey weeks, particularly in major teaching hospitals...
March 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#4
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28318185/neonatal-acute-liver-failure-a-diagnosis-challenge
#5
Mirta Ciocca, Fernando Álvarez
Neonatal acute liver failure is a rare, very severe disease with a high rate of mortality. It is clinically and etiologically different from acute liver failure seen in older children and adults. Coagulopathy with an international normalized ratio ≥ 3 is the critical parameter that defines it. The most common causes are fetal alloimmune hepatitis, previously called neonatal hemochromatosis, viral infections, metabolic disorders, and hemophagocytic lymphohistiocytosis. There is a group of treatable diseases that require a very early diagnosis for the prescription of an adequate treatment...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28318080/hepatitis-e-and-pregnancy-current-state
#6
REVIEW
María Teresa Pérez-Gracia, Beatriz Suay-García, María Luisa Mateos-Lindemann
Hepatitis E virus (HEV) is responsible for more than 50% of acute viral hepatitis cases in endemic countries. Approximately 2 billion individuals live in hepatitis E-endemic areas and, therefore, are at risk of infection. According to World Health Organization, HEV causes about 20.1 million infections and 70 000 deaths every year. In developing countries with poor sanitation, this disease is transmitted through contaminated water and is associated with large outbreaks, affecting hundreds or thousands of people...
March 20, 2017: Reviews in Medical Virology
https://www.readbyqxmd.com/read/28318053/statins-decrease-the-risk-of-decompensation-in-hbv-and-hcv-related-cirrhosis-a-population-based-study
#7
Fu-Ming Chang, Yen-Po Wang, Hui-Chu Lang, Chia-Fen Tsai, Ming-Chih Hou, Fa-Yauh Lee, Ching-Liang Lu
BACKGROUND & AIM: Statin decreased the risk of decompensation and mortality in veteran patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in general population or cirrhosis with other causes, such as hepatitis B virus (HBV) infection and alcohol, remains unknown. Statin also decreased the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients already with cirrhosis...
March 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28317104/contact-and-contagion-bighorn-sheep-demographic-states-vary-in-probability-of-transmission-given-contact
#8
Kezia R Manlove, E Frances Cassirer, Raina K Plowright, Paul C Cross, Peter J Hudson
1.Understanding both contact and probability of transmission given contact are key to managing wildlife disease. However, wildlife disease research tends to focus on contact heterogeneity, in part because probability of transmission given contact is notoriously difficult to measure. Here we present a first step toward empirically investigating probability of transmission given contact in free-ranging wildlife. 2.We used measured contact networks to test whether bighorn sheep demographic states vary systematically in infectiousness or susceptibility to Mycoplasma ovipneumoniae, an agent responsible for bighorn sheep pneumonia...
March 20, 2017: Journal of Animal Ecology
https://www.readbyqxmd.com/read/28316961/acute-delayed-or-late-infection-of-revision-total-hip-arthroplasty-treated-with-debridement-antibiotic-loaded-cement-beads-and-retention-of-the-prosthesis
#9
Jun-Dong Chang, In-Sung Kim, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316097/improved-postnatal-care-is-needed-to-maintain-gains-in-neonatal-survival-after-the-implementation-of-the-helping-babies-breathe-initiative
#10
J Wrammert, A Kc, U Ewald, M Målqvist
AIM: Helping Babies Breathe (HBB) is a neonatal resuscitation protocol proven to reduce intrapartum-related mortality in low-income settings. The aim of this study was to describe the timing and causes of neonatal in-hospital deaths before and after HBB training at a maternity health facility in Nepal. METHODS: A prospective cohort study was conducted at the facility between July 2012 and September 2013. All 137 staff, including medical doctors and midwives, were trained in January 2013...
March 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28315803/cranioplasty-complications-and-costs-a-national-population-level-analysis-using-the-marketscan-longitudinal-database
#11
Amy Li, Tej Deepak Azad, Anand Veeravagu, Inderpreet Bhatti, Chao Long, John K Ratliff, Gordon Li
OBJECTIVE: To characterize cranioplasty complications and costs at a population level using a longitudinal national claims database. METHODS: We identified cranioplasty patients between 2007-2014 in the MarketScan national database. We evaluated age, autograft usage, cranioplasty size, and cranioplasty timing on postoperative outcomes. We further analyzed associated costs. A subset analysis of adult cranioplasty patients with emergent indications, including stroke and trauma, was also performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28314997/clinical-and-microbiological-outcomes-in-haematogenous-spondylodiscitis-treated-conservatively
#12
Tiziana Ascione, Giovanni Balato, Sigismondo Luca Di Donato, Pasquale Pagliano, Francesco Granata, Gianluca Colella, Carlo Ruosi
INTRODUCTION: Spondylodiscitis refers to infections of the intervertebral disc and the adjacent vertebral body. Although it is still considered a rare condition, its rate is projected to increase. Mortality rate is considered to be low, but an estimated one third of the survivors experience residual disabilities. Literature shows that uncomplicated spondylodiscitis can be adequately treated by early antibiotic therapy and immobilization. The aim of the study is to evaluate the outcome of conservative treatment in patients with haematogenous spondylodiscitis...
March 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#13
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28303832/coagulase-negative-staphylococci-emerging-pathogen-in-central-nervous-system-shunt-infection
#14
Preeti Lata Bhatia, Sunil Lilani, Ritesh Shirpurkar, Chhaya Chande, Shrikant Joshi, Abhay Chowdhary
Central nervous system (CNS) shunts are commonly used to treat patients with hydrocephalus. Its placement is associated with increased risk of infection. The study was intended to evaluate infection rate associated with CNS shunt surgeries and identify risk factors for shunt infection. The frequency and characterisation of aetiological agents along with their antibiotic resistance pattern were also studied. A prospective study of 86 patients who underwent 97 surgeries over a period of 18 months was conducted...
January 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28303547/persistent-lymphopenia-is-a-risk-factor-for-icu-acquired-infections-and-for-death-in-icu-patients-with-sustained-hypotension-at-admission
#15
Christophe Adrie, Maxime Lugosi, Romain Sonneville, Bertrand Souweine, Stéphane Ruckly, Jean-Charles Cartier, Maité Garrouste-Orgeas, Carole Schwebel, Jean-François Timsit
BACKGROUND: Severely ill patients might develop an alteration of their immune system called post-aggressive immunosuppression. We sought to assess the risk of ICU-acquired infection and of mortality according to the absolute lymphocyte count at ICU admission and its changes over 3 days. METHODS: Adults in ICU for at least 3 days with a shock or persistent low blood pressure were extracted from a French ICU database and included. We evaluated the impact of the absolute lymphocyte count at baseline and its change at day 3 on the incidence of ICU-acquired infection and on the 28-day mortality rate...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28303545/low-prevalence-of-dhfr-and-dhps-mutations-in-pneumocystis-jirovecii-strains-obtained-from-a-german-cohort
#16
Isabelle Suárez, Lisa Roderus, Edeltraud van Gumpel, Norma Jung, Clara Lehmann, Gerd Fätkenheuer, Pia Hartmann, Georg Plum, Jan Rybniker
BACKGROUND: Pneumocystis pneumonia (PCP) is an opportunistic and potentially life-threatening infection of immunocompromised individuals. A combination of trimethoprim-sulfamethoxazole is widely used for prophylaxis and treatment of PCP. Polymorphisms in the drug targets, the dihydropteroate synthase (DHPS) or the dihydrofolate reductase (DHFR) are presumably a reason for treatment failure. METHODS: We retrospectively examined the prevalence of DHPS and DHFR mutations in Pneumocystis jirovecii isolates obtained from HIV-infected and non-HIV-infected PCP patients...
March 16, 2017: Infection
https://www.readbyqxmd.com/read/28302496/community-acquired-pneumococcal-pneumonia-in-virologically-suppressed-hiv-infected-adult-patients-a-matched-case-control-study
#17
Catia Cillóniz, Antoni Torres, Christian Manzardo, Albert Gabarrús, Juan Ambrosioni, Adriana Salazar, Felipe García, Adrián Ceccato, Josep Mensa, Jorge Puig de la Bella Casa, Asunción Moreno, Jose M Miró
BACKGROUND: The study aimed to investigate whether the clinical presentations and outcomes (length-of-stay (LOS), intensive care unit (ICU) admission and 30-day mortality) of pneumococcal pneumonia in virologically suppressed HIV-infected patients on ART with a CD4+ T cell count >350 cells/mm(3) are comparable to those seen in non-HIV-infected patients, using a case-control design. METHODS: A case-control study was carried out in Hospital Clinic, Barcelona, Spain (2001-2016)...
March 13, 2017: Chest
https://www.readbyqxmd.com/read/28301842/early-life-nutritional-programming-of-health-and-disease-in-the-gambia
#18
Sophie E Moore
BACKGROUND: Exposures during early life are increasingly being recognised as factors that play an important role in the aetiology of chronic non-communicable diseases (NCDs). The "Developmental Origins of Health and Disease" (DOHaD) hypothesis asserts that adverse early-life exposures - most notably unbalanced nutrition - leads to an increased risk for a range of NCDs and that disease risk is highest when there is a "mismatch" between the early- and later-life environments. Thus, the DOHaD hypothesis would predict highest risk in settings undergoing a rapid nutrition transition...
March 17, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28301690/optimal-dose-of-rabbit-thymoglobulin-in-conditioning-regimens-for-unmanipulated-haploidentical-hematopoietic-stem-cell-transplantation-long-term-outcomes-of-a-prospective-randomized-trial
#19
Ying-Jun Chang, Yu Wang, Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Yao Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Kai-Yan Liu, Xiao-Jun Huang
BACKGROUND: Antithymocyte globulin (ATG) is an important component of conditioning regimens to prevent severe graft-versus-host disease (GVHD) in patients undergoing unmanipulated, haploidentical stem cell transplantation (haplo-SCT). However, to the authors' knowledge, the optimal dose of ATG is unknown. METHODS: In this prospective, randomized trial, the authors compared the long-term outcomes of 2 ATG doses (rabbit thymoglobulin) used in myeloablative conditioning before unmanipulated haplo-HSCT...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28301424/joint-estimation-of-cd4-progression-and-survival-in-untreated-individuals-with-hiv-1-infection-a-pooled-analysis-of-data-from-25-countries
#20
T D Mangal
OBJECTIVE: We compiled the largest dataset of seroconverter cohorts to date from 25 countries across Africa, North America, Europe, and SE/E. Asia to simultaneously estimate transition rates between CD4 stages and death, in ART-naive HIV-1 infected individuals. DESIGN: A hidden Markov model incorporating a misclassification matrix was used to represent natural short-term fluctuations and measurement errors in CD4 counts. Covariates were included to estimate the transition rates and survival probabilities for each subgroup...
March 15, 2017: AIDS
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