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https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#1
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28208878/a-study-of-medication-compliance-in-geriatric-patients-with-chronic-illnesses-at-a-tertiary-care-hospital
#2
R Shruthi, R Jyothi, H P Pundarikaksha, G N Nagesh, T J Tushar
INTRODUCTION: Geriatric population is more prone for various chronic and recurrent illnesses like diabetes mellitus, hypertension, IHD, arthritic, neurodegenerative, gastrointestinal, ocular, genitourinary, respiratory disorders etc., which may require chronic medication with multiple drugs. Poor compliance in this age group accounts for medication wastage with increased cost of healthcare and substantial worsening of the disease with disability or death. Most of the human and economic costs associated with non adherence can be avoided by improving medication adherence...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207163/prognostic-value-and-development-of-a-scoring-system-in-horses-with-systemic-inflammatory-response-syndrome
#3
M-F Roy, G P S Kwong, J Lambert, S Massie, S Lockhart
BACKGROUND: Despite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown. OBJECTIVES: To study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome. ANIMALS: A total of 479 consecutive adult horse emergency admissions to a private primary referral practice. METHODS: Prospective observational study...
February 16, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28203127/a-case-of-mysterious-impacted-duodenal-foreign-body-presenting-with-halitosis
#4
Bhavtosh Dedania, Dipen Khanapara, Amruta Panwala, Murali Dharan
The majority of gastrointestinal (GI) foreign bodies (FBs) discovered in adults are the result of intentional ingestion, most of which are found in patients with a preexisting psychiatric illness, with substance abuse disorders, or in people seeking secondary gain. No similar case of internal injuries following unintentional ingestion of a barbecue grill cleaning brush bristle has been reported. A 58-year-old Caucasian male with no significant history presented with complaint of halitosis, not improving after oral care and dental hygiene measures...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28182515/acute-health-effects-after-the-elk-river-chemical-spill-west-virginia-january-2014
#5
Erica D Thomasson, Elizabeth Scharman, Ethan Fechter-Leggett, Danae Bixler, Sheri'f Ibrahim, Mary Anne Duncan, Joy Hsu, Melissa Scott, Suzanne Wilson, Loretta Haddy, Anthony Pizon, Sherry Burrer, Amy Wolkin, Lauren Lewis
OBJECTIVES: On January 9, 2014, approximately 10 000 gallons of a mixture of 4-methylcyclohexanemethanol and propylene glycol phenyl ether spilled into West Virginia's Elk River, contaminating the potable water supply of about 300 000 West Virginia residents. This study sought to describe acute health effects after the chemical spill. METHODS: We conducted a descriptive analysis using 3 complementary data sources: (1) medical records of patients who visited an emergency department during January 9-23, 2014, with illness potentially related to the spill; (2) West Virginia Poison Center caller records coded as "contaminated water" during January 9-23, 2014; and (3) answers to household surveys about health effects from a Community Assessment for Public Health Emergency Response (CASPER) questionnaire administered 3 months after the spill...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28168885/methylnaltrexone-versus-naloxone-for-opioid-induced-constipation-in-the-medical-intensive-care-unit
#6
Cristian Merchan, Diana Altshuler, John Papadopoulos
BACKGROUND: Opioid-induced constipation (OIC) is common in critically ill patients; it leads to complications that can increase hospital stay and, rarely, bowel perforation. Opioid antagonists are considered a logical approach to treat OIC; however, the agent of choice has yet to be determined. OBJECTIVE: To assess the effectiveness and safety of enteral naloxone (NTX) versus subcutaneous methylnaltrexone (MNTX) for the treatment of OIC in the medical intensive care unit...
March 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#7
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28164835/a-quick-reference-on-hyponatremia
#8
REVIEW
Julien Guillaumin, Stephen P DiBartola
The article focuses on causes of hyponatremia, including hypovolemia, diabetes mellitus and others. Hypovolemia is a major cause of hyponatremia in veterinary medicine. Hypovolemia causes a decrease in effective circulating volume, triggering antidiuretic hormone (ADH) secretion and free water retention, and develops after gastrointestinal losses, renal losses, hemorrhagic shock, hypoadrenocorticism, and other causes of hypovolemia. The article reviews the clinical approach to diagnosing the cause of hyponatremia in critically ill patients, including recognition of the syndrome of inappropriate ADH secretion (SIADH)...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28162113/a-large-outbreak-of-gastrointestinal-illness-at-an-open-water-swimming-event-in-the-river-thames-london
#9
V Hall, A Taye, B Walsh, H Maguire, J Dave, A Wright, C Anderson, P Crook
Open-water swimming is increasingly popular, often in water not considered safe for bathing. Limited evidence exists on the associated health risks. We investigated gastrointestinal illness in 1100 swimmers in a River Thames event in London, UK, to describe the outbreak and identify risk factors. We conducted a retrospective cohort study. Our case definition was swimmers with any: diarrhoea, vomiting, abdominal cramps lasting ⩾48 h, nausea lasting ⩾48 h, with onset within 9 days after the event. We used an online survey to collect information on symptoms, demographics, pre- and post-swim behaviours and open-water experience...
February 6, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28160215/the-impact-of-the-extreme-amazonian-flood-season-on-the-incidence-of-viral-gastroenteritis-cases
#10
Carmen Baur Vieira, Adriana de Abreu Corrêa, Michele Silva de Jesus, Sérgio Luiz Bessa Luz, Peter Wyn-Jones, David Kay, Mônica Simões Rocha, Marize Pereira Miagostovich
During the Amazonian flood season in 2012, the Negro River reached its highest level in 110 years, submerging residential and commercial areas which appeared associated with an elevation in the observed gastroenteritis cases in the city of Manaus. The aim of this study was to evaluate the microbiological water quality of the Negro River basin during this extreme flood to investigate this apparent association between the illness cases and the population exposed to the contaminated waters. Forty water samples were collected and analysed for classic and emerging enteric viruses...
February 3, 2017: Food and Environmental Virology
https://www.readbyqxmd.com/read/28159789/cross-comparison-of-human-wastewater-associated-molecular-markers-in-relation-to-fecal-indicator-bacteria-and-enteric-viruses-in-recreational-beach-waters
#11
B Hughes, D Beale, P G Dennis, S Cook, W Ahmed
: Detecting human wastewater contamination in recreational waters is of critical importance to regulators due to the risks posed to public health. To identify such risks, human wastewater associated microbial source tracking (MST) markers have been developed. At present, however, greater understanding of the suitability of these markers for the detection of diluted human wastewater in environmental waters is necessary to predict risk. Here, we compared the process limit of detection (PLOD) and quantification (PLOQ) of six human wastewater associated MST markers [Bacteroides HF183 (HF183), E...
February 3, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28157786/campylobacter-jejuni-and-associated-immune-mechanisms-short-term-effects-and-long-term-implications-for-infants-in-low-income-countries
#12
Amanda E Schnee, William A Petri
PURPOSE OF REVIEW: Campylobacter jejuni is recognized as one of the most common causes of food-borne gastrointestinal illness worldwide, resulting in a self-limiting dysentery in developed countries. However, it is increasingly gaining attention due to its association with postinfectious complications such as Guillain-Barré Syndrome and recently recognized importance in early childhood diarrhea in developing countries. We hypothesize that the inflammation mediated by C. jejuni infection causes environmental enteric dysfunction, and with contribution from diet and the host, microbiome may be responsible for growth faltering in children and developmental disability...
February 2, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28153339/characterization-of-admission-types-in-medically-hospitalized-patients-prescribed-clozapine
#13
Jonathan G Leung, M Earth Hasassri, Jason N Barreto, Sarah Nelson, Robert J Morgan
BACKGROUND: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia; however, rigorous monitoring is required to prevent or detect adverse drug events that contribute to morbidity and mortality. In addition to the Food and Drug Administration (FDA) boxed safety warnings specific to clozapine (agranulocytosis, hypotension, seizures, and cardiomyopathy/myocarditis), other adverse events such as pneumonia and gastrointestinal hypomotility have been reported in the literature to result in hospitalization...
November 18, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28151442/safe-drinking-water-and-waterborne-outbreaks
#14
N A Moreira, M Bondelind
The present work compiles a review on drinking waterborne outbreaks, with the perspective of production and distribution of microbiologically safe water, during 2000-2014. The outbreaks are categorised in raw water contamination, treatment deficiencies and distribution network failure. The main causes for contamination were: for groundwater, intrusion of animal faeces or wastewater due to heavy rain; in surface water, discharge of wastewater into the water source and increased turbidity and colour; at treatment plants, malfunctioning of the disinfection equipment; and for distribution systems, cross-connections, pipe breaks and wastewater intrusion into the network...
February 2017: Journal of Water and Health
https://www.readbyqxmd.com/read/28143418/reactivated-cytomegalovirus-proctitis-in-an-immunocompetent-patient-presenting-as-nosocomial-diarrhea-a-case-report-and-literature-review
#15
Chun-Yuan Lee, Yen-Hsu Chen, Po-Liang Lu
BACKGROUND: Reactivated cytomegalovirus (CMV) infection has been known to cause significant morbidity and mortality in immunocompromised patients. However, CMV disease rarely develops in immunocompetent patients, and reported cases often present with a mild, self-limiting course, without severe life-threatening sequelae. While the colon is the most common gastrointestinal site affected by CMV disease in immunocompetent patients, rectal involvement is rarely reported. CMV proctitis can present in two distinct forms, primary and reactivated...
February 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28138890/adult-atopic-dermatitis-with-comorbid-atopic-disease-is-associated-with-increased-risk-of-infections-a-population-based-cross-sectional-study
#16
Saisindhu Narala, Tissa R Hata
INTRODUCTION: Atopic dermatitis (AD) is related to other atopic diseases asthma and allergic rhinitis. It is known that those with asthma or allergic rhinitis have impaired immune responses that may predispose them to infections. This study sought to determine whether adult AD is associated with systemic infections, and whether association is strengthened in those with AD plus another atopic disease. METHODS: This cross-sectional study obtained information from adults in the 2010 and the 2012 National Health Interview Survey (NHIS)...
January 30, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/28137317/high-added-value-of-a-population-based-participatory-surveillance-system-for-community-acute-gastrointestinal-respiratory-and-influenza-like-illnesses-in-sweden-2013-2014-using-the-web
#17
A Pini, H Merk, A Carnahan, I Galanis, E VAN Straten, K Danis, M Edelstein, A Wallensten
In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Hӓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Hӓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Hӓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline...
January 31, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28116471/-gastrointestinal-infections
#18
C Lübbert, R Mutters
Infectious diarrhea is one of the most common diseases. This article summarizes the current state of the diagnostics and treatment and includes the most important pathogens, i.e. Norovirus, Rotavirus, Campylobacter, Salmonella, Shigella and pathogenic Escherichia coli. Infections caused by toxin-producing strains of Clostridium difficile are described in more detail due to the increasing importance. Symptomatic therapy is still the most important component of treatment. Empirical antibiotic therapy is reserved for severely ill patients with a high stool frequency, fever, bloody diarrhea, underlying immune deficiency or significant comorbidities...
February 2017: Der Internist
https://www.readbyqxmd.com/read/28110140/occurrence-of-norovirus-in-raw-sewage-a-systematic-literature-review-and-meta-analysis
#19
Sorina E Eftim, Tao Hong, Jeffrey Soller, Alexandria Boehm, Isaac Warren, Audrey Ichida, Sharon P Nappier
Human noroviruses (NoV) are a leading cause of recreational waterborne illnesses and responsible for the majority of viral-associated gastrointestinal illnesses nationwide. We conducted a systematic literature review of published peer-reviewed publications to identify NoV density data in wastewater influent, and provided an approach for developing pathogen density distributions, using the NoV data. Literature review inclusion criteria included scope, study quality, and data availability. A non-parametric bootstrap statistical model was used to estimate the NoV distribution in wastewater influent...
January 9, 2017: Water Research
https://www.readbyqxmd.com/read/28108748/-acute-hemorrhage-in-the-upper-gastrointestinal-tract
#20
M Busch, A Schneider, T Lankisch, T von Hahn
Bleeding in the upper gastrointestinal (GI) tract is a frequent and complex emergency. There are guidelines for acute medical treatment, established endoscopic treatment as well as surgical and radiological rescue procedures. Nevertheless, the mortality of the upper GI tract bleeding is high, which is due to the fact that affected patients often have serious preexisting illnesses.
January 20, 2017: Der Internist
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