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https://www.readbyqxmd.com/read/28531289/management-of-bacteriuria-in-veterans-affairs-hospitals
#1
Emily S Spivak, Muriel Burk, Rongping Zhang, Makoto M Jones, Melinda M Neuhauser, Matthew Bidwell Goetz, Francesca E Cunningham
Background: Bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking. Methods: Inpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission and all-cause mortality within 28 days of discharge...
May 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28529116/italian-consensus-guidelines-for-the-management-of-hepatitis-b-virus-infections-in-patients-with-rheumatoid-arthritis
#2
Marco Sebastiani, Fabiola Atzeni, Laura Milazzo, Luca Quartuccio, Carlo Scirè, Giovanni Battista Gaeta, Giovanni Lapadula, Orlando Armignacco, Marcello Tavio, Ignazio Olivieri, Pierluigi Meroni, Laura Bazzichi, Walter Grassi, Alessandro Mathieu, Claudio Mastroianni, Evangelista Sagnelli, Teresa Santantonio, Caterina Uberti Foppa, Massimo Puoti, Loredana Sarmati, Paolo Airò, Oscar Massimiliano Epis, Rossana Scrivo, Miriam Gargiulo, Agostino Riva, Andreina Manfredi, Giovanni Ciancio, Gianguglielmo Zehender, Gloria Taliani, Luca Meroni, Salvatore Sollima, Piercarlo Sarzi-Puttini, Massimo Galli
OBJECTIVES: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. METHODS: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations...
May 18, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28502138/presepsin-a-diagnostic-marker-for-sepsis-in-intensive-care-unit-patients
#3
Hanaa A Amer, Hala Ghareeb, Neama M Lotfy, Noran O El-Azizi, Asmaa Mahmoud Mahmoud
The aim of the study was to evaluate the usefulness of presepsin as a diagnostic marker of sepsis in intensive care unit (ICU) patients. Presepsin was measured by a rapid method based on a chemiluminescent enzyme immunoassay (PATHFAST). The clinical usefulness of presepsin to diagnose sepsis and septic shock was studied and compared with procalcitonin, C-reactive protein and total leucocytic count. This study was conducted on 53 individuals divided into 3 groups. Group I included 28 adult ICU patients with at least two diagnostic criteria for systemic inflammatory response syndrome (SIRS) as patient group, Group IIa 15 patients admitted to ICU for any medical cause but with no evidence of infection were enrolled as patient control group and further 10 apparently healthy subjects as healthy control group...
June 2016: Egyptian Journal of Immunology
https://www.readbyqxmd.com/read/28497242/-new-sepsis-3-definition-do-we-have-to-treat-sepsis-before-we-can-diagnose-it-from-now-on
#4
T Schmoch, M Bernhard, F Uhle, M Gründling, T Brenner, M A Weigand
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) have been available since the beginning of 2016. SEPSIS-3 completely replaces the old SIRS criteria in the definition of sepsis and defines sepsis from now on as "life-threatening organ dysfunction caused by a dysregulated host response to infection". However, it seems questionable whether in clinical practice the new definition is really superior to the old one. The most important question is the following: Is it helpful to have a definition that first recognizes a patient once organ dysfunction has occurred and the patient already needs intensive care?...
May 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28490915/older-patients-have-increased-risk-of-poor-outcomes-after-low-velocity-pedestrian-motor-vehicle-collisions
#5
Gerard A Baltazar, Parker Bassett, Amy J Pate, Akella Chendrasekhar
BACKGROUND: Motor vehicle collisions (MVCs) are a leading cause of injury in the US. While the probability of collision with a pedestrian (PMVC) has declined in recent years, the probability of a pedestrian fatality has risen. Our objective was to determine whether older age impacts potential outcomes in patients involved in low-velocity PMVCs. MATERIALS AND METHODS: We performed a retrospective-cohort study of adult patients aged >14 years involved in low-velocity pedestrian-MVCs (<15 miles per hour [24...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#6
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28471985/the-clinical-significance-of-scd14-st-for-blood-biomarker-in-neonatal-hematosepsis-a-diagnostic-accuracy-study
#7
Ting Xiao, Li-Ping Chen, Li-Hua Zhang, Fu-Huang Lai, Li Zhang, Qun-Feng Qiu, Rong-Liang Que, SiSi Xie, Ding-Chang Wu
Hematosepsis is a systemic inflammatory response syndrome (SIRS) with suspected or confirmed infection, which is the most common infectious disease in clinical neonatal intensive care unit. As the rapid development of neonatal hematosepsis caused by various basic diseases, the mortality rate is high, and there are some sequelae.We report the lasted study to date with 96 cases from Fujian Longyan First Hospital between 2013 and 2015. The aim of our study is to explore the value of soluble cluster of differentiation 14 subtype (sCD14-ST) in whole blood for differential diagnosis of neonatal hematosepsis at an early stage, and used in evaluation of the severity about sepsis combined with acute physiology and chronic health evaluation II (APACHE-II) score, procalcitonin (PCT), C reactive protein (CRP), and leukocyte (WBC)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28448400/comparison-of-the-performance-between-sepsis-1-and-sepsis-3-in-icus-in-china-a-retrospective-multicenter-study
#8
Baoli Cheng, Zhongwang Li, Jingya Wang, Guohao Xie, Xu Liu, Zhipeng Xu, Lihua Chu, Jialian Zhao, Yongming Yao, Xiangming Fang
The definition of sepsis was updated to sepsis-3 in February 2016. However, the performance of the previous and new definition of sepsis remains unclear in China. This was a retrospective multicenter study in 6 ICUs from 5 university-affiliated hospitals to compare the performance between sepsis-1 and sepsis-3 in China. From May 1, 2016 to June 1, 2016, 496 patients were enrolled consecutively. Data were extracted from the electronic clinical records. We evaluated the performance of sepsis-1 and sepsis-3 by measuring the area under the receiver operating characteristic curves (AUROC) to predict 28-day mortality rates...
April 26, 2017: Shock
https://www.readbyqxmd.com/read/28442215/-neopterin-levels-and-systemic-inflammatory-response-syndrome-in-pediatric-critically-ill-patients
#9
Raquel Gil-Gómez, Javier Blasco-Alonso, Pilar Sánchez-Yáñez, Vanessa Rosa-Camacho, Guillermo Milano Manso
INTRODUCTION: Neopterin and biopterin are sub-products of redox reactions, which act as cofactors of enzymes responsible for nitric oxide production. The hypothesis is presented that plasma neopterin and biopterin evolve differently during the first days in a critically ill child. METHODS: A single-centre prospective observational study was conducted on patients 7 days to 14 years admitted to our Paediatric Intensive Care Unit (PICU) and that met Systemic inflammatory response syndrome (SIRS) criteria...
April 22, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28427707/incidence-of-multiple-sclerosis-in-the-republic-of-ireland-a-prospective-population-based-study
#10
K O'Connell, N Tubridy, M Hutchinson, C McGuigan
BACKGROUND: Multiple sclerosis (MS) incidence and prevalence is increasing worldwide, with a disproportionally higher rate in women. Recent studies have questioned the presence of a latitudinal gradient in Europe. Ireland is a high prevalence country for MS with a previously reported North-South gradient making it ideal to further explore this concept. OBJECTIVES: In this study we prospectively determined the incidence rate of newly diagnosed MS in Ireland over a 12-month period and demonstrated the presence of a North-South gradient...
April 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28420038/retrospective-evaluation-of-coyote-attacks-in-dogs-154-cases-1997-2012
#11
Virginia M Frauenthal, Philip Bergman, Robert J Murtaugh
OBJECTIVE: To describe the clinical presentation and outcome of known attacks in client-owned dogs caused by the common coyote, Canis latrans. DESIGN: Retrospective observational study. SETTING: Private referral hospital. ANIMALS: One hundred fifty-four client-owned dogs known to be attacked by coyotes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Records from a private referral hospital from May 1997 through December 2012 were reviewed...
May 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28418697/a-two-biomarker-model-predicts-mortality-in-the-critically-ill-with-sepsis
#12
Carmen Mikacenic, Brenda L Price, Susanna Harju-Baker, D Shane O'Mahony, Cassianne Robinson-Cohen, Frank Radella, William O Hahn, Ronit Katz, David C Christiani, Jonathan Himmelfarb, W Conrad Liles, Mark M Wurfel
RATIONALE: Improving the prospective identification of patients with the systemic inflammatory response syndrome (SIRS) and sepsis at low for organ dysfunction and death is a major clinical challenge. OBJECTIVE: To develop and validate a multi-biomarker based prediction model for 28-day mortality in critically ill patients with SIRS and sepsis. METHODS: The derivation cohort (n=888) and internal test cohort (n=278) were from a prospective study of critically ill intensive care unit (ICU) patients meeting 2 of 4 SIRS criteria at an academic medical center for whom plasma was obtained within 24 hours...
April 18, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28416003/characterization-and-risk-estimate-of-cancer-in-patients-with-primary-sj%C3%A3-gren-syndrome
#13
Pilar Brito-Zerón, Belchin Kostov, Guadalupe Fraile, Daniel Caravia-Durán, Brenda Maure, Francisco-Javier Rascón, Mónica Zamora, Arnau Casanovas, Miguel Lopez-Dupla, Mar Ripoll, Blanca Pinilla, Eva Fonseca, Miriam Akasbi, Gloria de la Red, Miguel-Angel Duarte-Millán, Patricia Fanlo, Pablo Guisado-Vasco, Roberto Pérez-Alvarez, Antonio J Chamorro, César Morcillo, Iratxe Jiménez-Heredia, Isabel Sánchez-Berná, Armando López-Guillermo, Manuel Ramos-Casals
BACKGROUND: The purpose of this study is to characterize the risk of cancer in a large cohort of patients with primary Sjögren syndrome (SjS). METHODS: We had analyzed the development of cancer in 1300 consecutive patients fulfilling the 2002 SjS classification criteria. The baseline clinical and immunological characteristics and systemic activity (ESSDAI scores) were assessed at diagnosis as predictors of cancer using Cox proportional hazards regression analysis adjusted for age at diagnosis and gender...
April 17, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28411298/detecting-sepsis-are-two-opinions-better-than-one
#14
Poushali Bhattacharjee, Matthew M Churpek, Ashley Snyder, Michael D Howell, Dana P Edelson
The diagnosis of sepsis requires that objective criteria be met with a corresponding subjective suspicion of infection. We conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. Registered nurse (RN) suspicion of infection was collected every 12 hours and compared with medical doctor or advanced practice professional (MD/APP) suspicion, defined as an existing order for antibiotics or a new order for blood or urine cultures within the 12 hours before nursing screen time...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28409378/percutaneous-cholecystostomy-prognostic-factors-and-comparison-to-cholecystectomy
#15
Tyler J Loftus, Elisha M Collins, Camille G Dessaigne, Amber N Himmler, Alicia M Mohr, Ryan M Thomas, Charles E Hobson, George A Sarosi, William J Zingarelli
BACKGROUND: Data regarding long-term outcomes following percutaneous cholecystostomy (PC) are limited, and comparisons to cholecystectomy (CCY) are lacking. We hypothesized that chronic disease burden would predict 1-year mortality following PC, and that outcomes following PC and CCY would be similar when controlling for preprocedural risk factors. METHODS: We performed a 10-year retrospective cohort analysis of patients with acute cholecystitis managed by PC (n = 114) or CCY (n = 234)...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28401253/uncomplicated-acute-diverticulitis-identifying-risk-factors-for-severe-outcomes
#16
Rebekah Jaung, Malsha Kularatna, Jason P Robertson, Ryash Vather, David Rowbotham, Andrew D MacCormick, Ian P Bissett
BACKGROUND: The management of uncomplicated (Modified Hinchey Classification Ia) acute diverticulitis (AD) has become increasingly conservative, with a focus on symptomatic relief and supportive management. Clear criteria for patient selection are required to implement this safely. This retrospective study aimed to identify risk factors for severe clinical course in patients with uncomplicated AD. MATERIALS AND METHODS: Patients admitted to General Surgery at two New Zealand tertiary centres over a period of 18 months were included...
April 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28400194/increased-risk-of-colorectal-cancer-in-patients-with-multiple-serrated-polyps-and-their-first-degree-relatives
#17
Cecilia Egoavil, Miriam Juarez, Carla Guarinos, María Rodríguez-Soler, Eva Hernández-Illán, Cristina Alenda, Artemio Payá, Adela Castillejo, Anna Serradesanferm, Luis Bujanda, Fernando Fernández-Bañares, Joaquín Cubiella, Luisa de-Castro, Ana Guerra, Elena Aguirre, Alberto Herreros-de-Tejada, Xavier Bessa, Maite Herráiz, José-Carlos Marín-Gabriel, Judith Balmaña, Virginia Piñol, Miriam Cuatrecasas, Francesc Balaguer, Antoni Castells, José-Luis Soto, Pedro Zapater, Rodrigo Jover
BACKGROUND & AIMS: We investigated whether patients with multiple serrated polyps, but not meeting the World Health Organization criteria for serrated polyposis syndrome, and their relatives have similar risks for colorectal cancer (CRC) as those diagnosed with serrated polyposis. METHODS: We collected data from patients with more than 10 colonic polyps, recruited in 2008-2009 from 24 hospitals in Spain for a study of causes of multiple colonic polyps. We analyzed data from 53 patients who met the criteria for serrated polyposis and 145 patients who did not meet these criteria, but who had more than 10 polyps throughout the colon, of which more than 50% were serrated...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28376628/the-use-of-the-modified-neff-classification-in-the-management-of-acute-diverticulitis
#18
Laura Mora López, Roser Flores Clotet, Xavier Serra Aracil, Noemí Montes Ortega, Salvador Navarro Soto
INTRODUCTION: Acute diverticulitis (AD) is increasingly seen in Emergency services. The application of a reliable classification is vital for its safe and effective management. OBJECTIVE: To determine whether the combined use of the modified Neff radiological classification (mNeff) and clinical criteria (systemic inflammatory response syndrome [SIRS] and comorbidity) can ensure safe management of AD. MATERIAL AND METHODS: Prospective descriptive study in a population of patients diagnosed with AD by computerized tomography (CT)...
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28369197/risk-of-acute-coronary-heart-disease-after-sepsis-hospitalization-in-the-reasons-for-geographic-and-racial-differences-in-stroke-cohort
#19
Henry E Wang, Justin X Moore, John P Donnelly, Emily B Levitan, Monika M Safford
BACKGROUND: Sepsis is associated with long-term health consequences. We sought to determine the long-term risks of acute and fatal coronary heart disease (CHD) events after sepsis hospitalizations among community dwelling adults. METHODS: We analyzed data from 30,329 participants in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Sepsis events included hospitalizations for a serious infection with ≥2 systemic inflammatory response syndrome (SIRS) criteria...
March 23, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28342654/the-role-of-the-signal-intensity-ratio-on-fluid-attenuated-inversion-recovery-in-stroke-patients-achieving-successful-recanalization-with-endovascular-treatment
#20
Taehoon Kim, Jong-Won Chung, Myung Suk Jang, Mi Hwa Yang, Sang-Hwa Lee, Beom Joon Kim, Moon-Ku Han, Jae Hyoung Kim, Cheolkyu Jung, Jae-Sung Lim, Hee-Joon Bae
BACKGROUND: This study aimed to investigate whether fluid-attenuated inversion recovery (FLAIR) imaging hyperintensity can be used as a surrogate marker for the severity of ischemic insult and predict lesion growth. METHODS: Based on a prospective stroke registry database, we identified patients with ischemic stroke who were treated with endovascular treatment (EVT) within 8 hours of onset and achieved successful recanalization (modified thrombolysis in cerebral infarction ≥2B)...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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