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Critical care infectious diseases

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https://www.readbyqxmd.com/read/27882866/the-performance-of-community-health-workers-in-the-management-of-multiple-childhood-infectious-diseases-in-lira-northern-uganda-a-mixed-methods-cross-sectional-study
#1
Phillip Wanduru, Moses Tetui, Doreen Tuhebwe, Michael Ediau, Monica Okuga, Christine Nalwadda, Elizabeth Ekirapa-Kiracho, Peter Waiswa, Elizeus Rutebemberwa
BACKGROUND: Community health workers (CHWs) have the potential to reduce child mortality by improving access to care, especially in remote areas. Uganda has one of the highest child mortality rates globally. Moreover, rural areas bear the highest proportion of this burden. The optimal performance of CHWs is critical. In this study, we assess the performance of CHWs in managing malaria, pneumonia, and diarrhea in the rural district of Lira, in northern Uganda. DESIGNS: A cross-sectional mixed methods study was undertaken to investigate the performance of 393 eligible CHWs in the Lira district of Uganda...
2016: Global Health Action
https://www.readbyqxmd.com/read/27866110/dysbiosis-in-the-intensive-care-unit-microbiome-science-coming-to-the-bedside
#2
REVIEW
Georgios D Kitsios, Michael J Morowitz, Robert P Dickson, Gary B Huffnagle, Bryan J McVerry, Alison Morris
Complex microbial communities within the human body, constituting the microbiome, have a broad impact on human health and disease. A growing body of research now examines the role of the microbiome in patients with critical illness, such as sepsis and acute respiratory failure. In this article, we provide an introduction to microbiome concepts and terminology and we systematically review the current evidence base of the critical-illness microbiome, including 51 studies in animal models and pediatric and adult critically ill patients...
October 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#3
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#4
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
November 17, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27770080/lower-extremity-revascularization-in-end-stage-renal-disease-which-patients-benefit
#5
Douglas W Jones, Kirsten Dansey, Allen D Hamdan
Patients with end-stage renal disease (ESRD) who present with critical limb ischemia (CLI) have become an increasingly common and complex treatment problem for vascular surgeons. Dialysis patients have high short-term mortality rates regardless of whether revascularization is pursued. ESRD patients with CLI can be managed with: local wound care, endovascular or surgical revascularization, or amputation. Some patients may heal small foot wounds with local wound care alone, even if distal perfusion is marginal, as long as any infectious process has been controlled...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27729481/end-of-life-care-patterns-at-a-community-hospital-the-rest-of-the-story
#6
Kip Waite, Jane Rhule, David Bush, Barry Meisenberg
We undertook a retrospective review of a subset of expired patients at our community hospital to evaluate end-of-life care patterns and the use of advanced care planning tools among patients who died in the hospital. These 162 expired patients fell into 1 of the 3 diagnosis-related groups of cardiac, respiratory, or infectious disease. Seventy-nine percent of patients arrived to the hospital with no requested limitations in the extent of resuscitative efforts, even though 98% of all patients had major or extreme severity of illness and risk of mortality scores...
October 11, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27704388/primary-care-screening-methods-and-outcomes-for-asylum-seekers-in-new-york-city
#7
Nathan S Bertelsen, Elizabeth Selden, Polina Krass, Eva S Keatley, Allen Keller
Effective screening in primary care among asylum-seekers in the US is critical as this population grows. This study aimed to evaluate disease prevalence and screening methods in this high-risk group. Two hundred ten new clients from 51 countries, plus Tibet, who were accepted into a program for asylum seekers from 2012 to 2014 were included. Screening rates and outcomes for infectious, non-communicable, and mental illnesses were evaluated. Screening rates were highest for PTSD, depression, hepatitis B, and latent tuberculosis...
October 4, 2016: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/27692490/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#8
Leticia Yañez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, Maria 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...
September 27, 2016: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/27690721/contemporary-challenges-and-opportunities-in-the-diagnosis-and-outbreak-detection-of-multidrug-resistant-infectious-disease
#9
Teresa Cimmino, Stéphanie Le Page, Didier Raoult, Jean-Marc Rolain
The dissemination of multi-drug resistant bacteria (MDRB) has become a major public health concern worldwide because of the increase in infections caused by MDRB, the difficulty in treating them, and expenditures in patient care. Areas covered: We have reviewed challenges and contemporary opportunities for rapidly confronting infections caused by MDRB in the 21st century, including surveillance, detection, identification of resistance mechanisms, and action steps. Expert commentary: In this context, the first critical point for clinical microbiologists is to be able to rapidly detect an abnormal event, an outbreak and/or the spread of a MDRB with surveillance tools so that healthcare policies and therapies adapted to a new stochastic event that will certainly occur again in the future can be implemented...
October 2, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27646684/temporal-development-of-gut-microbiota-in-triclocarban-exposed-pregnant-and-neonatal-rats
#10
Rebekah C Kennedy, Russell R Fling, Michael S Robeson, Arnold M Saxton, Robert L Donnell, John L Darcy, David A Bemis, Jiang Liu, Ling Zhao, Jiangang Chen
Alteration of gut microbial colonization process may influence susceptibility of the newborn/infant to infectious and chronic disease. Infectious disease risk leads to widespread use of non-prescription antimicrobials in household products such as Triclocarban (TCC), an antimicrobial compound in personal care products. TCC concentrates in and is transferred through the milk to suckling offspring. TCC exposure during gestation and lactation significantly reduced phylogenetic diversity (PD) among exposed dams and neonates...
September 20, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27638133/management-of-neutropenic-patients-in-the-intensive-care-unit-newborns-excluded-recommendations-from-an-expert-panel-from-the-french-intensive-care-society-srlf-with-the-french-group-for-pediatric-intensive-care-emergencies-gfrup-the-french-society-of-anesthesia
#11
REVIEW
David Schnell, Elie Azoulay, Dominique Benoit, Benjamin Clouzeau, Pierre Demaret, Stéphane Ducassou, Pierre Frange, Matthieu Lafaurie, Matthieu Legrand, Anne-Pascale Meert, Djamel Mokart, Jérôme Naudin, Frédéric Pene, Antoine Rabbat, Emmanuel Raffoux, Patricia Ribaud, Jean-Christophe Richard, François Vincent, Jean-Ralph Zahar, Michael Darmon
Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27621509/taking-an-antibiotic-time-out-utilization-and-usability-of-a-self-stewardship-time-out-program-for-renewal-of-vancomycin-and-piperacillin-tazobactam
#12
EDITORIAL
Christopher J Graber, Makoto M Jones, Peter A Glassman, Charlene Weir, Jorie Butler, Kevin Nechodom, Chad L Kay, Amy E Furman, Thuong T Tran, Christopher Foltz, Lori A Pollack, Matthew H Samore, Matthew Bidwell Goetz
BACKGROUND: Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. OBJECTIVE: We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. METHODS: The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27592087/preventing-the-spread-of-multidrug-resistant-tuberculosis-and-protecting-contacts-of-infectious-cases
#13
G J Fox, H S Schaaf, A Mandalakas, E Chiappini, A Zumla, B J Marais
Prevention of multidrug-resistant and extensively drug-resistant tuberculosis (MDR/XDR-TB) is a top priority for global TB control, given the need to limit epidemic spread and considering the high cost, toxicity and poor treatment outcomes with available therapies. We performed a systematic literature review to evaluate the evidence for strategies to reduce MDR/XDR-TB transmission and disease progression. Rapid detection and timely initiation of effective treatment is critical to rendering MDR/XDR-TB cases non-infectious...
August 31, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27581665/knowledge-transfer-what-drug-information-would-specialist-doctors-need-to-support-their-clinical-practice-results-of-a-survey-and-of-three-focus-groups-in-italy
#14
Giulio Formoso, Paolo Rizzini, Maurizio Bassi, Paolo Bonfanti, Giuliano Rizzardini, Annalisa Campomori, Paola Mosconi
BACKGROUND: The wide offer of information on pharmaceuticals does not often fulfill physicians' needs: problems of relevance, access, quality and applicability are widely recognized, and doctors often rely on their own experience and expert opinions rather than on available evidence. A quali-quantitative research was carried out in Italy to provide an overview on information seeking behavior and information needs of doctors, in particular of infectious disease specialists, and to suggest an action plan for improving relevance, quality and usability of scientific information...
2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27573637/managing-the-oncologic-patient-with-suspected-pneumonia-in-the-intensive-care-unit
#15
D Leoni, B Encina, J Rello
INTRODUCTION: Solid cancer patients are frequently admitted in intensive care units for critical events. Improving survival rates in this setting is considered an achievable goal today. Respiratory failure is the main reason for admission, representing a primary target for research. AREAS COVERED: This review presents a diagnostic and therapeutic algorithm for pneumonia and other severe respiratory events in the solid cancer population. It aims to increase awareness of the risk factors and the different etiologies in this changing scenario in which neutropenia no longer seems to be a decisive factor in poor outcome...
October 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27532264/anomaly-detection-in-host-signaling-pathways-for-the-early-prognosis-of-acute-infection
#16
Kun Wang, Stanley Langevin, Corey S O'Hern, Mark D Shattuck, Serenity Ogle, Adriana Forero, Juliet Morrison, Richard Slayden, Michael G Katze, Michael Kirby
Clinical diagnosis of acute infectious diseases during the early stages of infection is critical to administering the appropriate treatment to improve the disease outcome. We present a data driven analysis of the human cellular response to respiratory viruses including influenza, respiratory syncytia virus, and human rhinovirus, and compared this with the response to the bacterial endotoxin, Lipopolysaccharides (LPS). Using an anomaly detection framework we identified pathways that clearly distinguish between asymptomatic and symptomatic patients infected with the four different respiratory viruses and that accurately diagnosed patients exposed to a bacterial infection...
2016: PloS One
https://www.readbyqxmd.com/read/27523588/a-case-report-of-poisoning-caused-by-incorrect-use-of-salvia
#17
Xianyi Yang, Danyang Chen, Lin Chai, Hui Duan, Hui Guo, Shuang Li, Min Xiao, Hongxia Chen
BACKGROUND Previous reports suggest that homoplantaginin, one of the compounds isolated from Salvia plebeia, has a protective and therapeutic effect on hepatocyte injury. We present a case of serious liver and kidney damage due to incorrect use of Salvia plebeia in a patient with a history of thyroid tumorectomy, who was successfully treated for poisoning with blood purification and systemic, comprehensive critical care. CASE REPORT A 54-year-old female patient with salvia intoxication combined with multiple organ dysfunction was transported to our emergency center by ambulance after presenting with nausea, vomiting, and skin yellowing...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27521441/executive-summary-management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia-2016-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-and-the-american-thoracic-society
#18
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27508058/can-free-open-access-resources-strengthen-knowledge-based-emerging-public-health-priorities-policies-and-programs-in-africa
#19
REVIEW
Ernest Tambo, Ghislaine Madjou, Christopher Khayeka-Wandabwa, Emmanuel N Tekwu, Oluwasogo A Olalubi, Nicolas Midzi, Louis Bengyella, Ahmed A Adedeji, Jeanne Y Ngogang
Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed...
2016: F1000Research
https://www.readbyqxmd.com/read/27506948/acinetobacter-spp-are-associated-with-a-higher-mortality-in-intensive-care-patients-with-bacteremia-a-survival-analysis
#20
Aline C Q Leão, Paulo R Menezes, Maura S Oliveira, Anna S Levin
BACKGROUND: It has been challenging to determine the true clinical impact of Acinetobacter spp., due to the predilection of this pathogen to colonize and infect critically ill patients, who often have a poor prognosis. The aim of this study was to assess whether Acinetobacter spp. bacteremia is associated with lower survival compared with bacteremia caused by other pathogens in critically ill patients. METHODS: This study was performed at Hospital das Clínicas, University of São Paulo, Brazil...
2016: BMC Infectious Diseases
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