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https://www.readbyqxmd.com/read/29474407/predicting-excess-cost-for-older-inpatients-with-clinical-complexity-a-retrospective-cohort-study-examining-cognition-comorbidities-and-complications
#1
Kasia Bail, Brian Draper, Helen Berry, Rosemary Karmel, John Goss
BACKGROUND: Hospital-acquired complications increase length of stay and contribute to poorer patient outcomes. Older adults are known to be at risk for four key hospital-acquired complications (pressure injuries, pneumonia, urinary tract infections and delirium). These complications have been identified as sensitive to nursing characteristics such as staffing levels and level of education. The cost of these complications compared to the cost of admission severity, dementia, other comorbidities or age has not been established...
2018: PloS One
https://www.readbyqxmd.com/read/29474380/predisposing-and-precipitating-factors-for-delirium-in-community-dwelling-older-adults-admitted-to-hospital-with-this-condition-a-prospective-case-series
#2
Emmanuelle Magny, Hélène Le Petitcorps, Maria Pociumban, Zineb Bouksani-Kacher, Éric Pautas, Joël Belmin, Sylvie Bastuji-Garin, Carmelo Lafuente-Lafuente
BACKGROUND: Factors associated with delirium among community-dwelling older adults have been poorly studied. Our aim was to describe the prevalence of predisposing and precipitating factors for delirium among patients admitted for delirium and to assess whether these factors were appropriately recognized at the first patient assessment at hospital. METHODS: Consecutive community-dwelling individuals admitted to three geriatric acute care units with a confirmed initial diagnosis of delirium were prospectively included...
2018: PloS One
https://www.readbyqxmd.com/read/29473387/elderly-patient-with-atypical-leiomyoma-of-the-bladder-presenting-as-flank-pain-a-case-report
#3
Mojtaba Ameli, Mina Rahmandoost
Atypical leiomyoma is a rare tumor of the bladder whose correct diagnosis with imaging techniques and cystoscopy is difficult. This tumor is prevalent in females and more common in middle age. In the present study we report a rare case of atypical leiomyoma presenting as flank pain and history of recurrent urinary tract infections in an elderly female. Ultrasound (US) showed that the wall of bladder was thickening and irregular, especially in the lower part of the bladder. US revealed hypoechoic solid mass with dimensions of 37 x 26 mm in the posterior bladder wall protruding into the bladder...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/29457583/financial-incentives-to-reduce-hospital-acquired-infections-under-alternative-payment-arrangements
#4
Catherine Crawford Cohen, Jianfang Liu, Bevin Cohen, Elaine L Larson, Sherry Glied
OBJECTIVE The financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers. DESIGN Matched case-control study. SETTING A large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals. PATIENTS All patients discharged in 2013 and 2014...
February 19, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29456226/three-cases-of-prune-belly-syndrome-at-the-lagos-state-university-teaching-hospital-ikeja
#5
Adaobi U Solarin, Elizabeth A Disu, Henry O Gbelee, Adeola B Animasahaun, Oluwatosin E Aremu, Eucharia Ogbuokiri, Gbemisola O Ogunnaike, Alaba Oladimeji
Prune belly syndrome (PBS) is a rare congenital disorder affecting 2.5 to 3.8/100,000 live births worldwide. Our objective of this report is to describe clinical manifestation, laboratory, and radiological characteristics of PBS in our patients, to highlight the limitations to offering appropriate patient care due to parents demanding discharge against medical advice and the need to increase the awareness regarding this rare disease. We report three cases; all referred after birth with lax abdominal wall, congenital anomalies of kidney, and urinary tract...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29450211/-actinotignum-schaalii-infection-a-clandestine-cause-of-sterile-pyuria
#6
Lucy E Horton, Sanjay R Mehta, Lejla Aganovic, Joshua Fierer
Actinotignum schaalii is an underappreciated cause of urinary tract infections (UTIs) in older adults. The diagnosis may be missed due to difficulty isolating and identifying the organism. Complications can result because the organism is intrinsically resistant to 2 commonly used drugs to treat UTI, as illustrated by this case.
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#7
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/29442147/-urosepsis
#8
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
February 7, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29441109/diagnostic-accuracy-of-urinary-biomarkers-in-infants-younger-than-3-months-with-urinary-tract-infection
#9
Nani Jung, Hye Jin Byun, Jae Hyun Park, Joon Sik Kim, Hae Won Kim, Ji Yong Ha
Purpose: The aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever. Methods: A total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission...
January 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29441108/is-vaginal-reflux-associated-with-urinary-tract-infection-in-female-children-under-the-age-of-36-months
#10
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group...
January 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29438980/trimethoprim-use-for-urinary-tract-infection-and-risk-of-adverse-outcomes-in-older-patients-cohort-study
#11
Elizabeth Crellin, Kathryn E Mansfield, Clémence Leyrat, Dorothea Nitsch, Ian J Douglas, Adrian Root, Elizabeth Williamson, Liam Smeeth, Laurie A Tomlinson
OBJECTIVE: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN: Cohort study. SETTING: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS: Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015...
February 9, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29437221/the-complexity-of-determining-whether-a-nursing-home-transfer-is-avoidable-at-time-of-transfer
#12
Kathleen T Unroe, Jennifer L Carnahan, Susan E Hickman, Greg A Sachs, Zachary Hass, Greg Arling
OBJECTIVES: To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores). DESIGN: As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital...
February 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29430718/renal-fungus-ball-in-a-patient-with-retroperitoneal-fibrosis-unique-complication-in-a-rare-disease
#13
Khaled Alobaid, Mostafa Faty, Ahmed El-Nahas, Abdullatif Al-Terki, Zia Khan
Candida fungus ball is a rare presentation of urinary tract infections among adult patients and is associated with considerable morbidity. Because clinical signs are not specific, diagnosis is often delayed. Furthermore, treatment is occasionally difficult, and the approach to such cases varies widely among different centers. In this report, we describe a patient with retroperitoneal fibrosis who developed a renal fungus ball. Management of this challenging case is discussed, and review of the literature is presented...
February 12, 2018: Mycoses
https://www.readbyqxmd.com/read/29427686/laboratory-diagnosis-of-urinary-tract-infections-towards-a-bilulu-consensus-guideline
#14
REVIEW
Matthijs Oyaert, Britt Van Meensel, Reinoud Cartuyvels, Johan Frans, Wim Laffut, Patricia Vandecandelaere, Hans De Beenhouwer
The BILULU study group consists of seven microbiologists of hospital laboratories located in the region of Flanders (Belgium). A major goal of the group is to standardize diagnostic microbiology procedures based on available evidence and, in the absence of evidence, based on general microbiological principles and expert opinion. Scientific evidence of current urine culture guidelines is incomplete and at some points guidelines don't indicate clear choice. The aim of this project was to develop a clear and unambiguous step-by-step guideline regarding the work-up of urine cultures...
February 7, 2018: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29422729/outcome-of-patients-admitted-to-a-tertiary-referral-intensive-care-unit-with-urosepsis-needing-source-control
#15
Chaitra C Rao, Pradeep Rangappa, Karthik Rao, Ipe Jacob
Introduction: Urosepsis is one of the common causes of admission to the Intensive Care Unit (ICU). It has traditionally been treated with antibiotics, but surgical management with Double J [DJ] ureteral stents is gaining popularity. This study compares patients with complicated urosepsis who underwent surgical source control by ureteral stenting with those managed medically. Materials and Methods: The study enrolled patients admitted to a tertiary adult ICU with a diagnosis of urosepsis over a period of 2 years...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29421775/increased-urine-interleukin-17-and-interleukin-22-levels-in-patients-with-candidal-urinary-tract-infection
#16
Kazem Ahmadikia, Parivash Kordbacheh, Pejman Shadpour, Sanam Nami, Abdolfattah Sarrafnejad, Mahmood Mahmoodi, Mahin Safara, Mohsen Rokni, Mohammad Yarahmadi, Shahram Mahmoudi, Mahdis Khezri, Farideh Zaini
INTRODUCTION: Candiduria is common in the hospitalized patients. This study aimed to quantify interleukin (IL)-17 and IL-22 levels in urine of candiduric patients. MATERIALS AND METHODS: A case-control study was conducted on inpatients at Hashemi Nejad Kidney Center. Thirty-four patients were identified with Candida species in their urine samples (> 103 colony-forming units per milliliter and presence of Candida species only). Urine samples with concomitant infections were excluded...
January 2018: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/29414075/cost-effective-flow-through-nanohole-array-based-biosensing-platform-for-the-label-free-detection-of-uropathogenic-e-coli-in-real-time
#17
Juan Gomez-Cruz, Srijit Nair, Angel Manjarrez-Hernandez, Sandra Gavilanes-Parra, Gabriel Ascanio, Carlos Escobedo
Rapid, inexpensive and sensitive detection of uropathogenic Escherichia coli (UPEC), a common cause of ascending urinary tract infections (UTIs) including cystitis and pyelonephritis, is critical given the increasing number of cases and its recurrence worldwide. In this paper, we present a label-free nanoplasmonic sensing platform, built with off-the-shelf optical and electronic components, which can detect intact UPEC at concentrations lower than the physiological limit for UTI diagnosis, in real time. The sensing platform consists of a red LED light source, lens assembly, CMOS detector, Raspberry Pi interface in conjugation with a metallic flow-through nanohole array-based sensor...
January 31, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29409577/proper-antibiotic-use-in-a-home-based-primary-care-population-treated-for-urinary-tract-infections
#18
Megan E Gee, James Ford, Erin L Conway, Michael C Ott, John A Sellick, Kari A Mergenhagen
OBJECTIVE: To evaluate the trends associated with diagnosis and treatment of urinary tract infections (UTI) in a home-based primary care population of Veterans Health System patients from 2006 to 2015. DESIGN: Retrospective cohort study. SETTING: Veterans Healthcare System. PARTICIPANTS: Home-based primary care patients treated for UTI from 2006 to 2015. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Appropriate therapy was determined based on the McGeer criteria...
February 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29408951/malaria-coinfections-in-febrile-pediatric-inpatients-a-hospital-based-study-from-ghana
#19
Benedikt Hogan, Daniel Eibach, Ralf Krumkamp, Nimako Sarpong, Denise Dekker, Benno Kreuels, Oumou Maiga-Ascofaré, Kennedy Gyau Boahen, Charity Wiafe Akenten, Yaw Adu-Sarkodie, Ellis Owusu-Dabo, Jürgen May
Background: The epidemiology of pediatric febrile illness is shifting in sub-Saharan Africa, but malaria remains a major cause of childhood morbidity and mortality. The present study describes causes of febrile illness in hospitalized children in Ghana and aims to determine the burden of malaria coinfections and their association with parasite densities. Methods: In a prospective study, children (aged ≥30 days and ≤15 years) with fever ≥38.0°C were recruited after admission to the pediatric ward of a primary hospital in Ghana...
February 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29406479/application-of-the-rochester-criteria-to-identify-febrile-infants-with-bacteremia-and-meningitis
#20
Paul L Aronson, Russell J McCulloh, Joel S Tieder, Lise E Nigrovic, Rianna C Leazer, Elizabeth R Alpern, Elana A Feldman, Fran Balamuth, Whitney L Browning, Mark I Neuman
OBJECTIVES: The Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid (CSF) testing. Prior studies have not specifically assessed criteria performance for bacteremia and bacterial meningitis (invasive bacterial infection). Our objective was to determine the sensitivity of the Rochester criteria for detection of invasive bacterial infection. METHODS: Retrospective cohort study of febrile infants aged 60 days or younger with invasive bacterial infections evaluated at 8 pediatric emergency departments from July 1, 2012, to June 30, 2014...
February 5, 2018: Pediatric Emergency Care
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