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https://www.readbyqxmd.com/read/28079263/comparison-of-rates-of-nephrotoxicity-associated-with-vancomycin-in-combination-with-piperacillin-tazobactam-administered-as-an-extended-versus-standard-infusion
#1
Mariam Mousavi, Tanya Zapolskaya, Marco R Scipione, Eddie Louie, John Papadopoulos, Yanina Dubrovskaya
STUDY OBJECTIVE: Despite recent reports of relatively high rates (16-37%) of acute kidney injury (AKI) in patients receiving the combination of intravenous piperacillin-tazobactam (PTZ) and vancomycin, data are limited evaluating the impact of PTZ infusion strategy on the occurrence of nephrotoxicity. The objective of this study was to compare the rates of nephrotoxicity in patients receiving vancomycin in combination with PTZ administered as an extended infusion (EI) versus a standard infusion (SI)...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#2
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28078655/single-dose-oritavancin-compared-to-standard-of-care-iv-antibiotics-for-acute-bacterial-skin-and-skin-structure-infection-in-the-outpatient-setting-a-retrospective-real-world-study
#3
Patrick J Anastasio, Pete Wolthoff, Annmarie Galli, Weihong Fan
INTRODUCTION: Cost-containment strategies are shifting the treatment of acute bacterial skin and skin structure infections (ABSSSI) from inpatient to outpatient settings. Current standard of care (SoC) requires multiple-dose regimens, which are associated with high hospitalization rates and high costs. Oritavancin, a new single-dose antibiotic for ABSSSI, may be suitable for outpatient therapy. This analysis evaluates the effectiveness, costs, and resource utilization of oritavancin vs...
January 11, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#4
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28077046/rational-use-of-rasburicase-for-the-treatment-and-management-of-tumor-lysis-syndrome
#5
Suhail A Shaikh, Bernard L Marini, Shannon M Hough, Anthony J Perissinotti
Purpose There is a lack of high-level evidence identifying meaningful outcomes and the optimal place in therapy of rasburicase in patients with, or at high risk for tumor lysis syndrome. The primary objective of this study was to evaluate and characterize outcomes resulting from an institution-specific guideline emphasizing supportive care, xanthine oxidase inhibitors, and lower doses of rasburicase. Methods In this retrospective chart review, we compared conservative rasburicase dosing, in accordance with newly developed UMHS tumor lysis syndrome guidelines, with aggressive rasburicase in adult patients (≥ 18 years of age) with hematological or solid tumor malignancies, and a uric acid level between 8 and 15 mg/dL...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28076861/potential-applications-of-smart-multifunctional-wearable-materials-to-gerontology
#6
David G Armstrong, Bijan Najafi, Mohsen Shahinpoor
Smart multifunctional materials can play a constructive role in addressing some very important aging-related issues. Aging affects the ability of older adults to continue to live safely and economically in their own residences for as long as possible. Thus, there will be a greater need for preventive, acute, rehabilitative, and long-term health care services for older adults as well as a need for tools to enable them to function independently during daily activities. The objective of this paper is, thus, to present a comprehensive review of some potential smart materials and their areas of applications to gerontology...
January 12, 2017: Gerontology
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#7
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28076315/meteorological-parameters-and-pollutants-on-asthma-exacerbation-in-bangalore-india-an-ecological-retrospective-time-series-study
#8
Kirthana U Kunikullaya, Ambarish Vijayaraghava, P Asha, Radhika Kunnavil, B V MuraliMohan
BACKGROUND: Literature has shown a significant association between asthma exacerbations and pollutant levels during that time. There is very limited evidence in India, especially Bangalore, for impacts of meteorological changes and pollution on asthma hospital admissions in adults. The objective was to study the impact of air pollution and meteorological parameters on asthma exacerbation in Bangalore. METHODS: This study quantitatively analyzed the relation between acute exacerbations of asthma and related admissions to the hospital with the air pollution and the meteorological conditions during that time...
January 11, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28076259/almond-appetizer-effect-on-glucose-tolerance-test-gtt-results
#9
Michael A Crouch, Robert T Slater
BACKGROUND: The extent to which glucose intolerance can be acutely improved with dietary modification is unclear. The purpose of this study was to test the effect of ingesting a low-calorie almond preload ("appetizer") 30 minutes before oral glucose tolerance testing in glucose-intolerant individuals without diabetes. METHODS: Twenty adults with prediabetes or isolated 1-hour glucose ≥160 mg/dL underwent 2 fasting oral glucose tolerance tests (GTTs)-1 standard GTT and 1 GTT 30 minutes after eating a half ounce (12) of dry-roasted almonds...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#10
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28068912/intensified-hand-hygiene-campaign-including-soap-and-water-wash-may-prevent-acute-infections-in-office-workers-as-shown-by-a-recognized-exposure-adjusted-analysis-of-a-randomized-trial
#11
Tapani Hovi, Jukka Ollgren, Carita Savolainen-Kopra
BACKGROUND: Variable exposure to causative agents of acute respiratory (RTI) or gastrointestinal tract infections (GTI) is a significant confounding factor in the analysis of the efficacy of interventions concerning these infections. We had an exceptional opportunity to reanalyze a previously published dataset from a trial assessing the effect of enhanced hand hygiene on the occurrence of RTI or GTI in adults, after adjustment for reported exposure and other covariates. METHODS: Twenty-one working units (designated clusters) each including at least 50 office employees, totaling 1,270 persons, were randomized into two intervention arms (either using water-and-soap or alcohol-rub in hand cleansing), or in the control arm...
January 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#12
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#13
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28065635/meals-enhancing-nutrition-after-discharge-findings-from-a-pilot-randomized-controlled%C3%A2-trial
#14
David R Buys, Anthony D Campbell, Alice Godfryd, Kellie Flood, Elizabeth Kitchin, Meredith L Kilgore, Sally Allocca, Julie L Locher
BACKGROUND: After older adults experience episodes of poor health or are hospitalized, they may not return to premorbid or prehospitalization eating behaviors. Furthermore, poor nutrition increases hospital readmission risk, but evidence-based interventions addressing these risks are limited. OBJECTIVE: This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program...
January 5, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28065183/paramyxovirus-outbreak-in-a-long-term-care-facility-the-challenges-of-implementing-infection-control-practices-in-a-congregate-setting
#15
Steven Schaeffer Spires, H Keipp Talbot, Carolyn A Pope, Thomas R Talbot
OBJECTIVE We report an outbreak of respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) infections in a dementia care ward containing 2 separately locked units (A and B) to heighten awareness of these pathogens in the older adult population and highlight some of the infection prevention challenges faced during a noninfluenza respiratory viral outbreak in a congregate setting. METHODS Cases were defined by the presence of new signs or symptoms that included (1) a single oral temperature ≥ 37...
January 9, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28062349/-best-case-worst-case-training-surgeons-to-use-a-novel-communication-tool-for-high-risk-acute-surgical-problems
#16
Jacqueline M Kruser, Lauren J Taylor, Toby C Campbell, Amy Zelenski, Sara K Johnson, Michael J Nabozny, Nicole M Steffens, Jennifer L Tucholka, Kris L Kwekkeboom, Margaret L Schwarze
CONTEXT: Older adults often have surgery in the months preceding death, which can initiate post-operative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. OBJECTIVE: To evaluate a structured training program designed to teach surgeons how to use BC/WC. METHODS: Twenty-five surgeons from one tertiary-care hospital completed a two-hour training session followed by individual coaching...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28061873/prophylactic-melatonin-for-delirium-in-intensive-care-pro-medic-study-protocol-for-a-randomised-controlled-trial
#17
F Eduardo Martinez, Matthew Anstey, Andrew Ford, Brigit Roberts, Miranda Hardie, Robert Palmer, Lynn Choo, David Hillman, Michael Hensley, Erin Kelty, Kevin Murray, Bhajan Singh, Bradley Wibrow
BACKGROUND: Delirium is an acute state of brain dysfunction characterised by fluctuating inattention and cognitive disturbances, usually due to illness. It occurs commonly in the intensive care unit (ICU), and it is associated with greater morbidity and mortality. It is likely that disturbances of sleep and of the day-night cycle play a significant role. Melatonin is a naturally occurring, safe and cheap hormone that can be administered to improve sleep. The main aim of this trial will be to determine whether prophylactic melatonin administered to critically ill adults, when compared with placebo, decreases the rate of delirium...
January 6, 2017: Trials
https://www.readbyqxmd.com/read/28060934/a-cohort-study-of-adult-patients-with-severe-dengue-in-taiwanese-intensive-care-units-the-elderly-and-aptt-prolongation-matter-for-prognosis
#18
Chih-Cheng Hsieh, Cong-Tat Cia, Jen-Chieh Lee, Junne-Ming Sung, Nan-Yao Lee, Po-Lin Chen, Te-Hui Kuo, Jo-Yen Chao, Wen-Chien Ko
BACKGROUND: There was a large dengue outbreak in Taiwan in 2015, in which the ages of the affected individuals were higher than those in other countries. The aim of this study was to explore the characteristics and prognostic factors for adults with severe dengue in intensive care units (ICUs). METHODS: All adults admitted to ICUs with dengue virus infection (DENV) at a medical center from July 1, 2015 to December 31, 2015 were enrolled. DENV was diagnosed by the presence of serum NS1 antigen, IgM antibodies to dengue virus, or dengue virus RNA by real-time reverse transcriptase polymerase chain reaction...
January 6, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#19
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28054924/a-mixed-methods-study-to-assess-interrater-reliability-and-nurse-perception-of-the-braden-scale-in-a-tertiary-acute-care-setting
#20
Chester H Ho, Amanda Cheung, Danielle Southern, Wrechelle Ocampo, Jaime Kaufman, David B Hogan, Barry Baylis, John M Conly, Henry T Stelfox, William A Ghali
Research regarding the reliability of the Braden Scale and nurses' perspectives on the instrument for predicting pressure ulcer (PU) risk in acute care settings is limited. A mixed-methods study was conducted in a tertiary acute care facility to examine interrater reliability (IRR) of the Braden Scale and its subscales, and a qualitative survey using semi-structured interviews was conducted among nurses caring for patients in acute care units to gain nurse perspective regarding scale usability. Data were extracted from a previous retrospective, randomized, controlled trial involving adult patients with compromised mobility receiving care in a tertiary acute care hospital in Canada...
December 2016: Ostomy/wound Management
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