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Critical care infectious diseases

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https://www.readbyqxmd.com/read/28409203/the-role-of-infection-models-and-pk-pd-modelling-for-optimising-care-of-critically-ill-patients-with-severe-infections
#1
REVIEW
T Tängdén, V Ramos Martín, T W Felton, E I Nielsen, S Marchand, R J Brüggemann, J B Bulitta, M Bassetti, U Theuretzbacher, B T Tsuji, D W Wareham, L E Friberg, J J De Waele, V H Tam, Jason A Roberts
Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens...
April 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#2
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28353449/influence-of-socio-economic-inequality-measured-by-the-gini-coefficient-on-meningitis-incidence-caused-by-mycobacterium-tuberculosis-and-haemophilus-influenzae-in-colombia-2008-2011
#3
Wilmer F Acevedo-Mendoza, Diana Paola Buitrago Gómez, Miguel Ángel Atehortua-Otero, Miguel Ángel Páez, Manuela Jiménez-Rincón, Guillermo J Lagos-Grisales, Alfonso J Rodríguez-Morales
Bacterial meningitis is an important cause of infectious neurological morbidity and mortality. Its incidence has decreased with the introduction of vaccination programmes against preventable agents. However, low-income and middle-income countries with poor access to health care still have a significant burden of the disease. Thus, the relationship between the Gini coefficient and H. influenzae and M. tuberculosis meningitis incidence in Colombia, during 2008-2011, was assessed. In this ecological study, the Gini coefficient was obtained from the Colombian Department of Statistics, incidence rates were calculated (cases/1,000,000 pop) and linear regressions were performed using the Gini coefficient, to assess the relationship between the latter and the incidence of meningitis...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28346490/effect-of-hiv-and-malaria-parasites-co-infection-on-immune-hematological-profiles-among-patients-attending-anti-retroviral-treatment-art-clinic-in-infectious-disease-hospital-kano-nigeria
#4
Feyisayo Ebenezer Jegede, Tinuade Ibijoke Oyeyi, Surajudeen Abiola Abdulrahman, Henry Akwen Mbah, Titilope Badru, Chinedu Agbakwuru, Oluwasanmi Adedokun
BACKGROUND: Human immunodeficiency virus (HIV) and malaria co-infection may present worse health outcomes in the tropics. Information on HIV/malaria co-infection effect on immune-hematological profiles is critical for patient care and there is a paucity of such data in Nigeria. OBJECTIVE: To evaluate immune-hematological profiles among HIV infected patients compared to HIV/malaria co-infected for ART management improvement. METHODS: This was a cross sectional study conducted at Infectious Disease Hospital, Kano...
2017: PloS One
https://www.readbyqxmd.com/read/28343420/portable-devices-and-mobile-instruments-for-infectious-diseases-point-of-care-testing
#5
Luc Bissonnette, Michel G Bergeron
Rapidity, simplicity, and portability are highly desirable characteristics of tests and devices designed for performing diagnostics at the point of care (POC), either near patients managed in healthcare facilities or to offer bioanalytical alternatives in external settings. By reducing the turnaround time of the diagnostic cycle, POC diagnostics can reduce the dissemination, morbidity, and mortality of infectious diseases and provide tools to control the global threat of antimicrobial resistance. Areas covered: A literature search of PubMed and Google Scholar, and extensive mining of specialized publications, Internet resources, and manufacturers' websites have been used to organize and write this overview of the challenges and requirements associated with the development of portable sample-to-answer diagnostics, and showcase relevant examples of handheld devices, portable instruments, and less mobile systems which may or could be operated at POC...
April 11, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28295777/can-ldl-cholesterol-be-too-low-possible-risks-of-extremely-low-levels
#6
Anders G Olsson, Bo Angelin, Gerd Assmann, Christoph J Binder, Ingemar Björkhem, Angel Cedazo-Minguez, Jonathan Cohen, Arnold von Eckardstein, Eduardo Farinaro, Dirk Müller-Wieland, Klaus G Parhofer, Paolo Parini, Robert S Rosenson, Jakob Starup-Linde, Matti J Tikkanen, Laurent Yvan-Charvet
Following the continuous accumulation of evidence supporting the beneficial role of reducing low-density lipoprotein cholesterol (LDL-C) levels in the treatment and prevention of atherosclerotic cardiovascular disease and its complications, therapeutic possibilities now exist to lower LDL-C to very low levels, similar to or even lower than those seen in newborns and nonhuman species. In addition to the important task of evaluating potential side-effects of such treatments, the question arises whether extremely low LDL-C levels per se may provoke adverse effects in humans...
March 14, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28290130/the-choosing-wisely-initiative-in-infectious-diseases
#7
REVIEW
Clara Lehmann, Reinhard Berner, Johannes R Bogner, Oliver A Cornely, Katja de With, Susanne Herold, Winfried V Kern, Sebastian Lemmen, Mathias W Pletz, Bernhard Ruf, Bernd Salzberger, Hans Jürgen Stellbrink, Norbert Suttorp, Andrew J Ullmann, Gerd Fätkenheuer, Norma Jung
OBJECTIVE: "Choosing Wisely" is a growing international campaign aiming at practice changes to improve patient health and safety by both, conduct of essential and avoidance of unnecessary diagnostic, preventive and therapeutic procedures. The goal is to create an easily recognizable and distributable list ("Choosing Wisely items") that addresses common over- and underuse in the management of infectious diseases. METHODS: The German Society of Infectious Diseases (DGI) participates in the campaign "Klug Entscheiden" by the German Society of Internal Medicine...
March 13, 2017: Infection
https://www.readbyqxmd.com/read/28288355/time-required-to-initiate-outbreak-and-pandemic-observational-research
#8
Asgar H Rishu, Nicole Marinoff, Lisa Julien, Mariana Dumitrascu, Nicole Marten, Shauna Eggertson, Su Willems, Stacy Ruddell, Dan Lane, Bruce Light, Henry T Stelfox, Philippe Jouvet, Richard Hall, Steven Reynolds, Nick Daneman, Robert A Fowler
PURPOSE: Observational research focused upon emerging infectious diseases such as Ebola virus, Middle East respiratory syndrome, and Zika virus has been challenging to quickly initiate. We aimed to determine the duration of start-up procedures and barriers encountered for an observational study focused upon such infectious outbreaks. MATERIALS AND METHODS: At 1 pediatric and 5 adult intensive care units, we measured durations from protocol receipt to a variety of outbreak research milestones, including research ethics board (REB) approval, data sharing agreement (DSA) execution, and patient study screening initiation...
March 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28288231/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#9
Leticia Yáñez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, María Angélica Marinovic
Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28274985/role-of-postgraduate-year-2-pharmacy-residents-in-providing-weekend-antimicrobial-stewardship-coverage-in-an-academic-medical-center
#10
Justin Siegfried, Cristian Merchan, Marco R Scipione, John Papadopoulos, Arash Dabestani, Yanina Dubrovskaya
PURPOSE: The integration of pharmacy residents into an antimicrobial stewardship program (ASP) is described, and data on the residents' ASP interventions and outcomes are reported. SUMMARY: ASP coverage of nighttime, holiday, and weekend shifts is often provided by infectious diseases (ID) medical fellows and staff pharmacists, potentially leading to inconsistent stewardship practices. As part of an initiative by a large urban hospital to provide around-the-clock, comprehensive ASP services 7 days a week, postgraduate year 2 (PGY2) pharmacy residents in ID or critical care were assigned to provide ASP coverage on weekends...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28267670/selective-digestive-decontamination-in-critically-ill-children-a-survey-of-canadian-providers
#11
Srinivas Murthy, Nazima Pathan, Brian H Cuthbertson
BACKGROUND: Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilization of this intervention among pediatric physicians in North America is unknown. METHODS: An electronic survey administered to pediatric critical care and pediatric infectious disease providers in Canada...
February 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28262433/evaluation-of-hand-hygiene-compliance-and-associated-factors-with-a-radio-frequency-identification-based-real-time-continuous-automated-monitoring-system
#12
J-C Dufour, P Reynier, S Boudjema, A Soto Aladro, R Giorgi, P Brouqui
BACKGROUND: Hand hygiene is a major means for preventing healthcare-associated infections. One critical point in understanding poor compliance is the lack of relevant markers used to monitor practices systematically. METHODS: This study analysed hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system in an infectious disease ward with 17 single bedrooms. Healthcare workers (HCWs) were tracked while performing routine care over 171 days...
April 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#13
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28224349/mapping-the-health-information-landscape-in-a-rural-culturally-diverse-region-implications-for-interventions-to-reduce-information-inequality
#14
A Susana Ramírez, Erendira Estrada, Ariana Ruiz
The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin...
February 21, 2017: Journal of Primary Prevention
https://www.readbyqxmd.com/read/28187026/an-algorithmic-approach-to-the-suspected-septic-wrist
#15
Jeffrey R Claiborne, Leslie G Branch, Michael Reynolds, Anthony J Defranzo
An acutely painful, erythematous wrist can be due to a variety of pathologic processes, including crystalline arthropathy, infection, trauma, osteoarthritis, and systemic disease. The broad differential diagnosis of the inflamed wrist and nonspecific clinical findings make accurate diagnosis challenging. There is no published clinical or laboratory criterion that reliably differentiates septic wrist arthritis from a sterile inflammatory arthropathy. For septic joint patients, long-term results are notably poorer in patients with a delay in treatment, therefore establishing evidenced-based guidelines deserves attention...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28159021/ebola-outbreak-preparedness-planning-a-qualitative-study-of-clinicians-experiences
#16
J Broom, A Broom, V Bowden
OBJECTIVES: The 2014-15 Ebola outbreak in West Africa highlighted the challenges many hospitals face when preparing for the potential emergence of highly contagious diseases. This study examined the experiences of frontline health care professionals in an Australian hospital during the outbreak, with a focus on participant views on information, training and preparedness, to inform future outbreak preparedness planning. STUDY DESIGN: Semi-structured interviews were conducted with 21 healthcare professionals involved in Ebola preparedness planning, at a hospital in Australia...
February 2017: Public Health
https://www.readbyqxmd.com/read/28138915/evaluation-of-internet-based-patient-education-materials-from-internal-medicine-subspecialty-organizations-will-patients-understand-them
#17
David R Hansberry, Nitin Agarwal, Elizabeth S John, Ann M John, Prateek Agarwal, James C Reynolds, Stephen R Baker
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine...
January 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28114880/factors-associated-with-patients-who-prefer-hiv-self-testing-over-health-professional-testing-in-an-emergency-department-based-rapid-hiv-screening-program
#18
Yu-Hsiang Hsieh, Kaylin J Beck, Richard E Rothman, Megan Gauvey-Kern, Alonzo Woodfield, Stephen Peterson, Danielle Signer, Charlotte A Gaydos
Kiosk-facilitated HIV self-testing has been shown to be accurate and well accepted by emergency department (ED) patients. We investigated factors associated with patients who preferred self-testing over testing performed by health professionals in an ED-based HIV screening program. This opt-in program evaluation studied 332 patients in an inner-city academic ED from February 2012 to April 2012, when a kiosk-based HIV self-testing program was standard of care. The first kiosk in the 2-stage system registered patients and assessed their interest in screening, while the second kiosk gathered demographic and risk factor information and also provided self-testing instructions...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28073898/two-stage-isothermal-enzymatic-amplification-for-concurrent-multiplex-molecular-detection
#19
Jinzhao Song, Changchun Liu, Michael G Mauk, Shelley C Rankin, James B Lok, Robert M Greenberg, Haim H Bau
BACKGROUND: The wide array of pathogens responsible for infectious diseases makes it difficult to identify causative pathogens with single-plex tests. Although multiplex PCR detects multiple targets, it is restricted to centralized laboratories, which delays test results or makes multiplexing unavailable, depriving healthcare providers of critical, real-time information. METHODS: To address the need for point-of-care (POC) highly multiplexed tests, we propose the 2-stage, nested-like, rapid (<40 min) isothermal amplification assay, dubbed rapid amplification (RAMP)...
March 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27999053/issues-in-antifungal-stewardship-an-opportunity-that-should-not-be-lost
#20
Chand Wattal, Arunaloke Chakrabarti, Jaswinder Kaur Oberoi, J Peter Donnelly, Rosemary A Barnes, B L Sherwal, Neeraj Goel, Sonal Saxena, George M Varghese, Rajeev Soman, Poonam Loomba, Bansidhar Tarai, Sanjay Singhal, Naimish Mehta, V Ramasubramanian, Dharma Choudhary, Yatin Mehta, Supradip Ghosh, Sumathi Muralidhar, Ravinder Kaur
Many countries have observed an increase in the incidence of invasive fungal infections (IFIs) over the past two decades with emergence of new risk factors and isolation of new fungal pathogens. Early diagnosis and appropriate antifungal treatment remain the cornerstones of successful outcomes. However, due to non-specific clinical presentations and limited availability of rapid diagnostic tests, in more than half of cases antifungal treatment is inappropriate. As a result, the emergence of antifungal resistance both in yeasts and mycelial fungi is becoming increasingly common...
April 1, 2017: Journal of Antimicrobial Chemotherapy
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