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Critically ill infectious diseases

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https://www.readbyqxmd.com/read/29910547/diagnosing-catheter-associated-urinary-tract-infection-in-critically-ill-patients-do-the-guidelines-help
#1
REVIEW
Sai Saran, Namrata S Rao, Afzal Azim
Catheter-associated urinary tract infection (CAUTI) is the leading cause of hospital-acquired infections in hospitalized patients in medical and surgical wards, but it is still commonly underdiagnosed in critically ill patients despite a higher device usage rate. The most commonly employed diagnostic criteria for such diagnosis come from the Infectious Disease Society of America and Centers for Disease Control and Prevention National Health Safety Network surveillance definition. It is surprising that no separate diagnostic criteria of CAUTI exist, for the critically ill patients - though these patients are of a different class of patients' altogether, due to decreased immunity, existence on multiple organ supports, and invasive lines, and an inability to communicate with a clinician...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29898981/rectal-and-naris-swabs-practical-and-informative-samples-for-analyzing-the-microbiota-of-critically-ill-patients
#2
Saumya Bansal, Jenny P Nguyen, Aleksandra Leligdowicz, Yu Zhang, Kevin C Kain, Daniel R Ricciuto, Bryan Coburn
Commensal microbiota are immunomodulatory, and their pathological perturbation can affect the risk and outcomes of infectious and inflammatory diseases. Consequently, the human microbiota is an emerging diagnostic and therapeutic target in critical illness. In this study, we compared four sample types-rectal, naris, and antecubital swabs and stool samples-for 16S rRNA gene microbiota sequencing in intensive care unit (ICU) patients. Stool samples were obtained in only 31% of daily attempts, while swabs were reliably obtained (≥97% of attempts)...
June 27, 2018: MSphere
https://www.readbyqxmd.com/read/29887138/the-cellular-and-pathologic-prion-protein
#3
Andrew C Gill, Andrew R Castle
The cellular prion protein, PrPC , is a small, cell surface glycoprotein with a function that is currently somewhat ill defined. It is also the key molecule involved in the family of neurodegenerative disorders called transmissible spongiform encephalopathies, which are also known as prion diseases. The misfolding of PrPC to a conformationally altered isoform, designated PrPTSE , is the main molecular process involved in pathogenesis and appears to precede many other pathologic and clinical manifestations of disease, including neuronal loss, astrogliosis, and cognitive loss...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29874192/procalcitonin-guided-antibiotic-therapy-an-expert-consensus
#4
Michele Bartoletti, Massimo Antonelli, Francesco Arturo Bruno Blasi, Ivo Casagranda, Arturo Chieregato, Roberto Fumagalli, Massimo Girardis, Filippo Pieralli, Mario Plebani, Gian Maria Rossolini, Massimo Sartelli, Bruno Viaggi, Pierluigi Viale, Claudio Viscoli, Federico Pea
BACKGROUND: Procalcitonin (PCT) is a useful biomarker of bacterial infection and its use is associated to reduced duration of antibiotic therapy in the setting of intensive care medicine. To address the need of practical guidance for the use of PCT in various clinical settings, a group of experts was invited to participate at a consensus process with the aims of defining the rationale for appropriate use of PCT and for improving the management of critically ill patients with sepsis. METHODS: A group of 14 experts from anesthesiology and critical care, infectious diseases, internal medicine, pulmonology, clinical microbiology, laboratory medicine, clinical pharmacology and methodology provided expert opinion through a modified Delphi process, after a comprehensive literature review...
June 6, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29860163/a-systematic-review-exploring-the-relationship-between-infection-and-sudden-unexpected-death-between-2000-and-2016-a-forensic-perspective
#5
REVIEW
Mia M Kruger, Lorna J Martin, Sairita Maistry, Laura J Heathfield
Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur...
May 21, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29795610/virus-survey-in-populations-of-two-subspecies-of-bent-winged-bats-miniopterus-orianae-bassanii-and-oceanensis-in-south-eastern-australia-reveals-a-high-prevalence-of-diverse-herpesviruses
#6
Peter H Holz, Linda F Lumsden, Julian Druce, Alistair R Legione, Paola Vaz, Joanne M Devlin, Jasmin Hufschmid
While bats are often viewed as carriers of infectious disease agents, little research has been conducted on the effects these potential pathogens may have on the bat populations themselves. The southern bent-winged bat (Miniopterus orianae bassanii) is a critically endangered subspecies endemic to south-eastern Australia. Population numbers of this bat have been declining for the past 50 years, but the reasons for this are unclear. As part of a larger study to determine if disease could be a contributing factor to this decline, 351 southern bent-winged bats from four locations were captured, and oral swabs were collected and tested for the presence of potentially pathogenic viruses...
2018: PloS One
https://www.readbyqxmd.com/read/29779827/zika-virus-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#7
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Pravin Amin
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. For those with symptoms, the presentation is similar to dengue fever with body aches, joint pain, fatigue, malaise, fever and conjunctivitis lasting up to seven days...
April 5, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29720475/comparison-of-qsofa-with-current-emergency-department-tools-for-screening-of-patients-with-sepsis-for-critical-illness
#8
Robert M Rodriguez, John C Greenwood, Thomas J Nuckton, Bryan Darger, Frances S Shofer, Dawn Troeger, Soo Y Jung, Kelly G Speich, Joel Valencia, J Hope Kilgannon, Danny Fernandez, Brigitte M Baumann
OBJECTIVE: We sought to compare the quick sequential organ failure assessment (qSOFA) to systemic inflammatory response syndrome (SIRS), severe sepsis criteria and lactate levels for their ability to identify ED patients with sepsis with critical illness. METHODS: We conducted this multicenter retrospective cohort study at five US hospitals, enrolling all adult patients admitted to these hospitals from their EDs with infectious disease-related illnesses from 1 January 2016 to 30 April 2016...
June 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29686661/molecular-imaging-of-invasive-pulmonary-aspergillosis-using-immunopet-mri-the-future-looks-bright
#9
REVIEW
Christopher R Thornton
Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of immuno-compromised humans caused by the ubiquitous environmental mold Aspergillus . Biomarker tests for the disease lack sensitivity and specificity, and culture of the fungus from invasive lung biopsy is slow, insensitive, and undesirable in critically ill patients. A computed tomogram (CT) of the chest offers a simple non-intrusive diagnostic procedure for rapid decision making, and so is used in many hematology units to drive antifungal treatment...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#10
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29600241/a-standardized-needs-assessment-tool-to-inform-the-curriculum-development-process-for-pediatric-resuscitation-simulation-based-education-in-resource-limited-settings
#11
Nicole Shilkofski, Amanda Crichlow, Julie Rice, Leslie Cope, Ye Myint Kyaw, Thazin Mon, Sarah Kiguli, Julianna Jung
Introduction: Under five mortality rates (UFMR) remain high for children in low- and middle-income countries (LMICs) in the developing world. Education for practitioners in these environments is a key factor to improve outcomes that will address United Nations Sustainable Development Goals 3 and 10 (good health and well being and reduced inequalities). In order to appropriately contextualize a curriculum using simulation, it is necessary to first conduct a needs assessment of the target learner population...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29598889/severe-malaria-presenting-to-the-emergency-department-a-collaborative-approach-utilizing-exchange-transfusion-and-artesunate
#12
David Zodda, Gabrielle Procopio, Kevin Hewitt, Andrew Parrish, Bindu Balani, Joseph Feldman
We describe the case of a previously healthy 33year-old male pilot recently arrived to the United States from Africa. The patient presented to our ED febrile and disoriented, with projectile coffee-ground emesis. He was later found to have severe malaria and cerebral parasitemia. Due to the severity of his illness, the patient received the anti-malarial medication Artesunate as well as several exchange transfusions. Within 48h his parasitic load was reduced from 42% to 0.4%. The following is an account of a collaborative effort that spans the specialties of emergency medicine, infectious disease, and critical care medicine...
March 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29593035/a-highly-conserved-leucine-in-mammarenavirus-matrix-z-protein-is-required-for-z-interaction-with-the-virus-l-polymerase-and-z-stability-in-cells-harboring-an-active-viral-ribonucleoprotein
#13
Masaharu Iwasaki, Juan C de la Torre
Mammarenaviruses cause chronic infections in their natural rodent hosts. Infected rodents shed infectious virus into excreta. Humans are infected through mucosal exposure to aerosols or direct contact of abraded skin with fomites, resulting in a wide range of manifestations from asymptomatic or mild febrile illness to severe life-threatening hemorrhagic fever. The mammarenavirus matrix Z protein has been shown to be a main driving force of virus budding and to act as a negative regulator of viral RNA synthesis...
June 1, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29551092/clinical-assessment-is-a-neglected-component-of-outbreak-preparedness-evidence-from-refugee-camps-in-greece
#14
Amanda M Rojek, Kassiani Gkolfinopoulou, Apostolos Veizis, Angeliki Lambrou, Lyndsey Castle, Theano Georgakopoulou, Karl Blanchet, Takis Panagiotopoulos, Peter W Horby
BACKGROUND: Refugees may have an increased vulnerability to infectious diseases, and the consequences of an outbreak are more severe in a refugee camp. When an outbreak is suspected, access to clinical information is critical for investigators to verify that an outbreak is occurring, to determine the cause and to select interventions to control it. Experience from previous outbreaks suggests that the accuracy and completeness of this information is poor. This study is the first to assess the adequacy of clinical characterisation of acute medical illnesses in refugee camps...
March 19, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29544449/development-and-validation-of-a-diagnostic-model-for-early-differentiation-of-sepsis-and-non-infectious-sirs-in-critically-ill-children-a-data-driven-approach-using-machine-learning-algorithms
#15
Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29515942/implementation-of-a-comprehensive-curriculum-in-personal-finance-for-medical-fellows
#16
Yuval D Bar-Or, Henry E Fessler, Dipan A Desai, Sammy Zakaria
INTRODUCTION: Many residents and fellows complete graduate medical education having received minimal unbiased financial planning guidance. This places them at risk of making ill-informed financial decisions, which may lead to significant harm to them and their families. Therefore, we sought to provide fellows with comprehensive unbiased financial education and empower them to make timely, constructive financial decisions. METHODS: A self-selected cohort of cardiovascular disease, pulmonary and critical care, and infectious disease fellows (n = 18) at a single institution attended a live, eight-hour interactive course on personal finance...
January 1, 2018: Curēus
https://www.readbyqxmd.com/read/29503436/prognostic-risk-factors-in-ventilator-associated-pneumonia
#17
Ziyaattin Karakuzu, Remzi Iscimen, Halis Akalin, Nermin Kelebek Girgin, Ferda Kahveci, Melda Sinirtas
BACKGROUND Ventilator-associated pneumonia (VAP) is a nosocomial infection commonly seen in patients in intensive care units (ICU). This study aimed to analyze factors affecting prognosis of patients diagnosed with VAP. MATERIAL AND METHODS Critically ill patients with VAP were retrospectively evaluated between June 2002 and June 2011 in the ICU. VAP diagnosis was made according to 2005 ATS/IDSA (Infectious Diseases Society of America/American Thoracic Society) criteria. First pneumonia attacks of patients were analyzed...
March 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29481673/macrophage-activation-syndrome-in-adults-recent-advances-in-pathophysiology-diagnosis-and-treatment
#18
Stuart J Carter, Rachel S Tattersall, Athimalaipet V Ramanan
Haemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome, which if not promptly treated, can lead rapidly to critical illness and death. HLH is termed macrophage activation syndrome (MAS) when associated with rheumatic disease (where it is best characterized in systemic JIA) and secondary HLH (sHLH) when associated with other triggers including malignancy and infection. MAS/sHLH is rare and coupled with its mimicry of other conditions, is underrecognized. These inherent challenges can lead to diagnostic and management challenges in multiple medical specialties including haematology, infectious diseases, critical care and rheumatology...
February 21, 2018: Rheumatology
https://www.readbyqxmd.com/read/29408912/effect-of-maternal-height-on-caesarean-section-and-neonatal-mortality-rates-in-sub-saharan-africa-an-analysis-of-34-national-datasets
#19
Esther Arendt, Neha S Singh, Oona M R Campbell
RATIONALE: The lifecycle perspective reminds us that the roots of adult ill-health may start in-utero or in early childhood. Nutritional and infectious disease insults in early life, the critical first 1000 days, are associated with stunting in childhood, and subsequent short adult stature. There is limited or no opportunity for stunted children above 2 years of age to experience catch-up growth. Some previous research has shown short maternal height to lead to adverse birth outcomes...
2018: PloS One
https://www.readbyqxmd.com/read/29352265/type-i-ifn-operates-pyroptosis-and-necroptosis-during-multidrug-resistant-a-baumannii-infection
#20
Yang Li, Xiaomin Guo, Chunmiao Hu, Yan Du, Chuansheng Guo, Di Wang, Weiheng Zhao, Gonghua Huang, Chunliang Li, Qiumin Lu, Ren Lai, Tao Xu, Xiaopeng Qi
Multidrug-resistant Acinetobacter baumannii, a common pathogen responsible for nosocomial infections, is the main cause for outbreaks of infectious diseases, such as pneumonia, meningitis, and bacteremia, especially among critically ill patients. Epidemic A. baumannii is a growing public health concern as it is resistant to all existing antimicrobial agents, thereby necessitating the development of new therapeutic approaches to mount an effective immune response against this bacterial pathogen. In this study, we identified a critical role for type I interferon (IFN) in epigenetic regulation during A...
January 19, 2018: Cell Death and Differentiation
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