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https://www.readbyqxmd.com/read/29049319/clinical-outcome-and-prognostic-factors-associated-with-invasive-pulmonary-aspergillosis-an-11-year-follow-up-report-from-taiwan
#1
Kuo-Shao Sun, Ching-Fang Tsai, Solomon Chih-Cheng Chen, Wan-Chun Huang
BACKGROUND: Invasive pulmonary aspergillosis (IPA) has high mortality rate but prognostic factors are not well established. The aim of our study was to evaluate the trend in in-hospital mortality over a period of 11 years and identify factors affecting the clinical outcomes of patients with IPA. METHOD: We conducted a nationwide inpatient population study using data from the Taiwan National Health Insurance Research Database. A total of 407 IPA patients from 2002 to 2012 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/29029170/use-of-a-structured-panel-process-to-define-antimicrobial-prescribing-appropriateness-in-critical-care
#2
Linda D Dresser, Chaim M Bell, Marilyn Steinberg, Niall D Ferguson, Stephen Lapinsky, Neil Lazar, Patricia Murphy, Jeffrey M Singh, Andrew M Morris
Background: Antimicrobial prescribing is frequently reported as appropriate or inappropriate, particularly in the ICU. However, the definitions used are non-standardized and lack validity and reliability. Objectives: To develop standardized definitions of appropriateness for antimicrobial prescribing in the critical care setting. Methods: We used consensus-based modified Delphi and RAND appropriateness methodology to develop criteria to define appropriateness of antimicrobial prescribing...
September 26, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28971655/-reduction-of-antibiotic-consumption-in-rambam-health-care-campus-the-role-of-an-antibiotic-stewardship-program
#3
Roni Bitterman, Ayelet Raz-Pasteur, Zaher S Azzam, Amir Karban, Yishai Levy, Tony Hayek, Eyal Braun, Ilana Oren, Yaron Bar-Lavi, Imad Kassis, Khetam Hussein, Mical Paul
INTRODUCTION: Antibiotic stewardship programs (ASP) are designed to optimize antibiotic use in hospitals. Antibiotic consumption is one of the measures assessing the effects of ASPs. AIMS: To evaluate the effect of an ASP on antibiotic consumption in our hospital and compare it to hospitals in Israel and worldwide. METHODS: Between October 2012 and March 2013 an ASP was implemented in Rambam Hospital. The program included educational activities, publication of local guidelines for empirical antibiotic treatment, structured infectious diseases consultations, pre-authorization antibiotic restrictions and stop orders...
September 2017: Harefuah
https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#4
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28890524/diagnosis-and-management-of-patients-with-paroxysmal-sympathetic-hyperactivity-following-acute-brain-injuries-using-a-consensus-based-diagnostic-tool-a-single-institutional-case-series
#5
Shigeo Godo, Shigemi Irino, Atsuhiro Nakagawa, Yu Kawazoe, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Paroxysmal sympathetic hyperactivity (PSH) is a distinct syndrome of episodic sympathetic hyperactivities following severe acquired brain injury, characterized by paroxysmal transient fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and specific posturing. PSH remains to be an under-recognized condition with a diagnostic pitfall especially in the intensive care unit (ICU) settings due to the high prevalence of concomitant diseases that mimic PSH. A consensus set of diagnostic criteria named PSH-Assessment Measure (PSH-AM) has been developed recently, which is consisted of two components: a diagnosis likelihood tool derived from clinical characteristics of PSH, and a clinical feature scale assigned to the severity of each sympathetic hyperactivity...
September 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28821454/low-dose-antithymocyte-globulin-for-graft-versus-host-disease-prophylaxis-in-matched-unrelated-allogeneic-hematopoietic-stem-cell-transplantation
#6
Adam Bryant, Ranjeeta Mallick, Lothar Huebsch, David Allan, Harold Atkins, Grizel Anstee, Mitchell Sabloff, Nicholas Scrivens, Dawn Maze, Chris Bredeson, Natasha Kekre
Graft-versus-host disease (GVHD) is a leading cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (alloHCT). Prophylactic in vivo T cell depletion with antithymocyte globulin (ATG) has been associated with decreased GVHD rates in many alloHCT settings. Despite decades of clinical study, optimal ATG dosing has not been established. Understanding that higher rates of GVHD are observed with matched unrelated donor (MUD) versus matched related donor (MRD) alloHCT, at our institution MUD alloHCT recipients have historically had low-dose Thymoglobulin (total dose, 2...
August 15, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#7
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28730159/antibiotic-prescribing-for-adults-hospitalized-in-the-etiology-of-pneumonia-in-the-community-study
#8
Sara Tomczyk, Seema Jain, Anna M Bramley, Wesley H Self, Evan J Anderson, Chris Trabue, D Mark Courtney, Carlos G Grijalva, Grant W Waterer, Kathryn M Edwards, Richard G Wunderink, Lauri A Hicks
BACKGROUND: Community-acquired pneumonia (CAP) 2007 guidelines from the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recommend a respiratory fluoroquinolone or beta-lactam plus macrolide as first-line antibiotics for adults hospitalized with CAP. Few studies have assessed guideline-concordant antibiotic use for patients hospitalized with CAP after the 2007 IDSA/ATS guidelines. We examine antibiotics prescribed and associated factors in adults hospitalized with CAP...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28693625/a-role-for-antimicrobial-stewardship-in-clinical-sepsis-pathways-a-prospective-interventional-study
#9
John Burston, Suman Adhikari, Andrew Hayen, Heather Doolan, Melissa L Kelly, Kathy Fu, Tomas O Jensen, Pamela Konecny
OBJECTIVE To evaluate the impact of early infectious diseases (ID) antimicrobial stewardship (AMS) intervention on inpatient sepsis antibiotic management. DESIGN Interventional, nonrandomized, controlled study. SETTING Tertiary-care referral hospital, Sydney, Australia. PATIENTS Consecutive, adult, non-intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015. INTERVENTION All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations...
September 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28665060/clinical-impacts-of-donor-types-of-living-vs-deceased-donors-predictors-of-one-year-mortality-in-patients-with-liver-transplantation
#10
Eun Jung Kim, Seungjin Lim, Chong Woo Chu, Je Ho Ryu, Kwangho Yang, Young Mok Park, Byung Hyun Choi, Tae Beom Lee, Su Jin Lee
Transplantation studies about the clinical differences according to the type of donors are mostly conducted in western countries with rare reports from Asians. The aims of this study were to evaluate the clinical impacts of the type of donor, and the predictors of 1-year mortality in patients who underwent liver transplantation (LT). This study was performed for liver transplant recipients between May 2010 and December 2014 at the Pusan National University Yangsan Hospital. A total of 185 recipients who underwent LT were analyzed...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28656546/epidemiology-of-acute-kidney-injury-in-patients-with-stroke-a-retrospective-analysis-from-the-neurology-icu
#11
Dongxue Wang, Yidan Guo, Yin Zhang, Zhaoxia Li, Ang Li, Yang Luo
Acute kidney injury (AKI) is proven to be an independent risk factor for adverse clinical outcomes in patients with stroke, but data about the epidemiology of AKI in these patients are not well characterized. Therefore, we investigated the incidence, risk factors, and the impact of AKI on the clinical outcomes in a group of Chinese patients with stroke. We retrospectively recruited 647 stroke patients from the neurology ICU between 2012 and 2013. AKI was identified according to the 2012 KDIGO criteria. Baseline estimated glomerular filtration rate (eGFR) was calculated using modified Chronic Kidney Disease Epidemiology Collaboration equation for Chinese patients...
June 27, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28625166/impact-of-gram-stain-results-on-initial-treatment-selection-in-patients-with-ventilator-associated-pneumonia-a-retrospective-analysis-of-two-treatment-algorithms
#12
Jumpei Yoshimura, Takahiro Kinoshita, Kazuma Yamakawa, Asako Matsushima, Naoki Nakamoto, Toshimitsu Hamasaki, Satoshi Fujimi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common and serious problem in intensive care units (ICUs). Several studies have suggested that the Gram stain of endotracheal aspirates is a useful method for accurately diagnosing VAP. However, the usefulness of the Gram stain in predicting which microorganisms cause VAP has not been established. The purpose of this study was to evaluate whether a Gram stain of endotracheal aspirates could be used to determine appropriate initial antimicrobial therapy for VAP...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28607636/impact-of-garlic-tablets-on-nosocomial-infections-in-hospitalized-patients-in-intensive-care-units
#13
Hossein Madineh, Farrokh Yadollahi, Farshad Yadollahi, Ebrahim Pouria Mofrad, Majid Kabiri
BACKGROUND: Nosocomial infections are one of the main causes of mortality and morbidity in hospitals, especially in intensive care units (ICUs). OBJECTIVE: The aim of this study was to examine the impact of garlic tablets on nosocomial infections in hospitalized patients in intensive care units. METHODS: This clinical trial was carried out on 94 patients, admitted to the intensive care units in Kashani and Al-Zahra hospitals from January 21, 2014 to December 20, 2014...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28584373/prospective-analysis-of-skin-findings-in-surgical-critically-ill-patients-intensive-care-unit
#14
Suzan Demir Pektas, Arzu Kahveci Demir
BACKGROUND: Intensive Care Units (ICUs) are places where critically ill patients are managed. AIM: We aimed to investigate skin disorders that developed in critically ill surgical patients during their stay in the ICU. METHODS: The prevalence of dermatological disorders and factors affecting their clinical features was prospectively analyzed in surgical ICU patients. We recorded age, sex, type of ICU, comorbidities, skin disorders, time to consultation, duration of ICU stay, and mortality rate...
May 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28579084/j%C3%A3-vea-consensus-guidelines-for-the-treatment-of-candida-peritonitis-and-other-intra-abdominal-fungal-infections-in-non-neutropenic-critically-ill-adult-patients
#15
Javier Pemán, Gerardo Aguilar, Juan Carlos Valía, Miguel Salavert, David Navarro, Rafael Zaragoza
BACKGROUND: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. AIMS: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection...
July 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28569640/prevalence-of-serum-antibody-titers-against-canine-distemper-virus-and-canine-parvovirus-in-dogs-hospitalized-in-an-intensive-care-unit
#16
Jennifer L Mahon, Elizabeth A Rozanski, April L Paul
OBJECTIVE To determine the prevalence of dogs hospitalized in an intensive care unit (ICU) with serum antibody titers against canine distemper virus (CDV) and canine parvovirus (CPV). DESIGN Prospective observational study. ANIMALS 80 dogs. PROCEDURES Dogs hospitalized in an ICU for > 12 hours between February 1 and June 1, 2015, that had at least 0.25 mL of serum left over from diagnostic testing were eligible for study inclusion. Dogs with serum antibody titers > 1:32 (as determined by serum neutralization) and > 1:80 (as determined by hemagglutination inhibition) were considered seropositive for CDV and CPV, respectively...
June 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28569127/a-retrospective-study-of-patient-factors-that-indicate-provider-nonadherence-to-an-institutional-clostridium-difficile-treatment-guideline
#17
Jeremy T Siehnel, Jill E Lavigne, Elizabeth A Rightmier, Will T Bossard, Na Li, Judianne C Slish
BACKGROUND: Clostridium difficile infection (CDI) is treated most often with metronidazole or vancomycin. Both have been effective in treatment of mild to moderate infection. In more severe cases, vancomycin may be more effective. OBJECTIVES: The primary objectives were to quantify the severity of CDI and to describe overall adherence to the institutional CDI guideline. Secondary objectives were to assess factors associated with adherence to the guidelines. METHODS: Retrospective analysis of the electronic medical record was used to evaluate adherence to institutional guidelines...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28520621/outbreaks-in-the-adult-icus
#18
Hasan M Al-Dorzi, Yaseen M Arabi
PURPOSE OF REVIEW: Infectious disease outbreaks in the critical care setting are common and serious consequence. This article reviews and summarizes recent outbreaks in the adult ICUs. RECENT FINDINGS: Outbreaks of multidrug-resistant bacteria, fungi, and emerging viruses in ICUs from different countries are common. Outbreak investigation relies on epidemiologic methods, microbiologic studies, and molecular typing methods. Overuse of antibiotics, gaps in implementing infection prevention measures, and contaminated environment are common causes of ICU outbreaks...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28464807/prognostic-factors-in-hospitalized-community-acquired-pneumonia-a-retrospective-study-of-a-prospective-observational-cohort
#19
Akihiro Ito, Tadashi Ishida, Hironobu Tokumasu, Yasuyoshi Washio, Akio Yamazaki, Yuhei Ito, Hiromasa Tachibana
BACKGROUND: To date, only few studies have examined the prognostic factors of community-acquired pneumonia (CAP) defined according to the latest criteria, which excludes healthcare-associated pneumonia (HCAP). Therefore, we aimed to investigate the factors that affect prognosis, and evaluate the usefulness of existing pneumonia severity scores for predicting the prognosis of CAP. METHODS: We retrospectively analyzed patients with CAP, excluding HCAP, who were enrolled prospectively between April 2007 and February 2016...
May 2, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28455155/-spike-in-acute-asthma-exacerbations-during-enterovirus-d68-epidemic-in-japan-a-nation-wide-survey
#20
Seigo Korematsu, Kengo Nagashima, Yasunori Sato, Mizuho Nagao, Shunji Hasegawa, Haruna Nakamura, Shiro Sugiura, Katsushi Miura, Kenji Okada, Takao Fujisawa
BACKGROUND: In September 2015, Japan experienced an unusual increase in acute asthma hospitalizations of children that coincided with an enterovirus D68 (EV-D68) epidemic. The objective of this study is to investigate whether EV-D68 had a causal relationship with the spike in asthma hospitalizations. METHODS: A nation-wide retrospective survey of asthma hospitalizations of children was performed for the period from January 2010 through October 2015. The Japanese Society of Pediatric Allergy and Clinical Immunology asked its affiliated hospitals to report monthly numbers of hospitalizations, ICU admissions and mechanical ventilations due to acute asthma exacerbation...
April 25, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
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