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https://www.readbyqxmd.com/read/29031240/colonization-of-oropharynx-and-lower-respiratory-tract-in-critical-patients-risk-of-ventilator-associated-pneumonia
#1
Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
OBJECTIVE: To investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied...
October 2, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29029356/total-hip-arthroplasty-dislocation-after-cardioversion-a-case-report
#2
Ahmed Siddiqi, Carl T Talmo, James V Bono
New onset postoperative atrial fibrillation (AF) is the most common perioperative arrhythmia in the elderly. The incidence after total joint arthroplasty is much lower than other non-cardiac surgeries. Since postoperative atrial fibrillation can cause increased length of hospital stay, mortality, and healthcare costs, it is critical to focus on prevention and prompt management. New onset atrial fibrillation is treated with rhythm control for patients who demonstrate hemodynamic instability or refractory to rate control measures...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29029328/predicting-deaths-in-a-resource-limited-neonatal-intensive-care-unit-in-nepal
#3
Dhruba Shrestha, Bhim G Dhoubhadel, Christopher M Parry, Bina Prajapati, Koya Ariyoshi, Chandeshwar Mahaseth
Background: This study aimed to determine whether the Neonatal Acute Physiology (SNAP) scoring system (SNAP II) and with perinatal extension (SNAP II PE) can be used to predict neonatal deaths in a resource-limited neonatal intensive care unit in Nepal. Methods: A prospective observational study was conducted in a neonatal intensive care unit (NICU) of Kanti Children's Hospital in Kathmandu, Nepal. Data required for the SNAP II and SNAP II PE scores were collected...
September 28, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29029209/genetic-evidence-for-the-introduction-of-rhagoletis-pomonella-diptera-tephritidae-into-the-northwestern-united-states
#4
Sheina B Sim, Meredith M Doellman, Glen R Hood, Wee L Yee, Thomas H Q Powell, Dietmar Schwarz, Robert B Goughnour, Scott P Egan, Gilbert St Jean, James J Smith, Tracy E Arcella, Jason D K Dzurisin, Jeffrey L Feder
The apple maggot fly, Rhagoletis pomonella Walsh (Diptera: Tephritidae), is a serious quarantine pest in the apple-growing regions of central Washington and Oregon. The fly is believed to have been introduced into the Pacific Northwest via the transport of larval-infested apples near Portland, Oregon, within the last 40 yr. However, R. pomonella also attacks native black hawthorn, Crataegus douglasii Lindley (Rosales: Rosaceae), and introduced ornamental hawthorn, Crataegus monogyna Jacquin, in the region. It is, therefore, possible that R...
October 6, 2017: Journal of Economic Entomology
https://www.readbyqxmd.com/read/29029188/an-analysis-of-the-epidemic-of-kpc-producing-klebsiella-pneumoniae-convergence-of-two-evolutionary-mechanisms-creates-the-perfect-storm
#5
Laura J Rojas, George M Weinstock, Elsa De La Cadena, Lorena Diaz, Rafael Rios, Blake M Hanson, Joseph S Brown, Purva Vats, Daniel S Phillips, Hoan Nguyen, Kristine M Hujer, Adriana Correa, Mark D Adams, Federico Perez, Erica Sodergren, Apurva Narechania, Paul J Planet, Maria V Villegas, Robert A Bonomo, Cesar A Arias
Background: Carbapenem resistance is a critical health care challenge worldwide. Particularly concerning is the widespread dissemination of Klebsiella pneumoniae carbapenemase (KPC). K. pneumoniae harboring blaKPC (KPC-Kpn) is endemic in many areas including United States, where the epidemic was primarily mediated by the clonal dissemination of Kpn ST258. We postulated that the spread of blaKPC in other regions occurs by different and more complex mechanisms. To test this, we investigated the evolution and dynamics of spread of KPC-Kpn in Colombia, where KPC became rapidly endemic after emerging in 2005...
September 27, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29029111/short-term-and-mid-term-survival-in-bronchial-sleeve-resection-by-robotic-system-versus-thoracotomy-for-centrally-located-lung-cancer
#6
Chang Gu, Xufeng Pan, Yong Chen, Jun Yang, Heng Zhao, Jianxin Shi
OBJECTIVES: The aim of this study was to compare the short-term and mid-term results of patients with centrally located lung cancer who underwent bronchial sleeve resection by robotic system or thoracotomy. METHODS: From September 2014 to September 2015, 103 patients, including 17 robotic and 86 open cases, were included in our study. All the clinicopathological data, operative details and follow-up information were investigated. RESULTS: There were no intraoperative deaths...
September 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29029105/comparative-performance-of-transcatheter-aortic-valve-in-valve-implantation-versus-conventional-surgical-redo-aortic-valve-replacement-in-patients-with-degenerated-aortic-valve-bioprostheses-systematic-review-and-meta-analysis
#7
Miroslaw Gozdek, Giuseppe Maria Raffa, Piotr Suwalski, Michalina Kolodziejczak, Lech Anisimowicz, Jacek Kubica, Eliano Pio Navarese, Mariusz Kowalewski
The objective of this report was to directly compare, by means of a systematic review and meta-analysis, redo surgical aortic valve replacement (re-sAVR) with valve-in-valve transcatheter aortic valve implantation (ViV TAVI) for patients with failed degenerated aortic bioprostheses. Multiple databases were screened for all available reports comparing ViV TAVI with re-sAVR in patients with failing degenerated aortic bioprostheses. The primary outcome was all-cause mortality determined from the longest available survival data...
September 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29028991/a-bayesian-procedure-for-estimating-the-causal-effects-of-nursing-home-bed-hold-policy
#8
Roee Gutman, Orna Intrator, Tony Lancaster
Nursing home bed-hold policies provide continuity of care for Medicaid beneficiaries by paying nursing homes to reserve beds so residents can return to their facility of occupancy following an acute hospitalization. In 2001, Michigan implemented bed-hold policies in nursing homes. We investigated the impact of these policies on mortality and hospitalizations using 1999-2004 quarterly data from nursing homes in Michigan and nursing homes in 11 states that did not implement such policies. Synthetic Control has been used to estimate the effects of policies by accounting for changes over time unrelated to the intervention...
October 3, 2017: Biostatistics
https://www.readbyqxmd.com/read/29028932/surgical-pleth-index-prediction-of-postoperative-pain-in-children
#9
T Ledowski, D Sommerfield, L Slevin, J Conrad, B S von Ungern-Sternberg
Background: Surgical Pleth Index (SPI) is a non-invasive, dimensionless score (0-100) aimed to allow an estimate of intraoperative nociception. Thus, it may be a useful tool to guide intraoperative analgesia. However, no optimum SPI target range for the use in children has yet been defined. It was the aim of this study to define a clinically appropriate SPI target to predict moderate-severe postoperative pain in children. Methods: After ethics approval 105 children (2-16 yr) undergoing elective sevoflurane/opioid-based anaesthesia were included...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028917/comparative-usability-of-modern-anaesthesia-ventilators-a-human-factors-study
#10
J Spaeth, T Schweizer, A Schmutz, H Buerkle, S Schumann
Background: The anaesthesia ventilator represents the key equipment for intraoperative respiratory care. Improper operation of this device may threaten a patient's health. A self-explanatory interface facilitates handling and decreases the risk of operating errors. This study systematically evaluates the usability of user interfaces in four modern anaesthesia ventilators. Methods: Twenty naïve operators were asked to execute 20 tasks on each of four different anaesthesia ventilators (Avance CS2™, GE Healthcare; Flow-i™, Maquet; and Perseus™ and Primus™, Dräger) in a randomized order...
October 3, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028788/efficacy-and-safety-of-pembrolizumab-in-patients-enrolled-in-keynote-030-in-the-united-states-an-expanded-access-program
#11
Tara C Gangadhar, Wen-Jen Hwu, Michael A Postow, Omid Hamid, Adil Daud, Roxana Dronca, Richard Joseph, Steven J O'Day, F S Hodi, Anna C Pavlick, Harriet Kluger, Romina P Oxborough, Aiming Yang, Mihaela Gazdoiu, Debra A Kush, Scot Ebbinghaus, April K S Salama
KEYNOTE-030 (ClinicalTrials.gov ID, NCT02083484) was a global expanded access program that allowed access to pembrolizumab, an antiprogrammed death 1 antibody, for patients with advanced melanoma before its regulatory approval. Patients with unresectable stage III/IV melanoma that progressed after standard-of-care therapy, including ipilimumab and, if BRAF mutant, a BRAF inhibitor, were eligible to receive pembrolizumab 2 mg/kg every 3 weeks. Response was assessed by immune-related response criteria by investigator review...
November 2017: Journal of Immunotherapy
https://www.readbyqxmd.com/read/29028774/seeking-humanizing-care-in-patient-centered-care-process-a-grounded-theory-study
#12
Mohammad Ali Cheraghi, Maryam Esmaeili, Mahvash Salsali
Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician)...
November 2017: Holistic Nursing Practice
https://www.readbyqxmd.com/read/29028756/financial-performance-of-hospitals-in-the-mississippi-delta-region-under-the-hospital-readmissions-reduction-program-and-hospital-value-based-purchasing-program
#13
Hsueh-Fen Chen, Saleema Karim, Fei Wan, Adrienne Nevola, Michael E Morris, T Mac Bird, J Mick Tilford
BACKGROUND: Previous studies showed that the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-based Purchasing Program (HVBP) disproportionately penalized hospitals caring for the poor. The Mississippi Delta Region (Delta Region) is among the most socioeconomically disadvantaged areas in the United States. The financial performance of hospitals in the Delta Region under both HRRP and HVBP remains unclear. OBJECTIVE: To compare the differences in financial performance under both HRRP and HVBP between hospitals in the Delta Region (Delta hospitals) and others in the nation (non-Delta hospitals)...
November 2017: Medical Care
https://www.readbyqxmd.com/read/29028742/intraoperative-esmolol-as-an-adjunct-for-perioperative-opioid-and-postoperative-pain-reduction-a-systematic-review-meta-analysis-and-meta-regression
#14
Amanda M Gelineau, Michael R King, Karim S Ladha, Sara M Burns, Timothy Houle, T Anthony Anderson
BACKGROUND: Esmolol is an ultrashort β-1 receptor antagonist. Recent studies suggest a role for esmolol in pain response modulation. The authors performed a meta-analysis to determine if the intraoperative use of esmolol reduces opioid consumption or pain scores. METHODS: PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, pubget, and Google Scholar were searched. Studies were included if they were randomized, placebo- or opioid-controlled trials written in English, and performed on patients 18 years of age or older...
October 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29028696/brain-oxygen-optimization-in-severe-traumatic-brain-injury-phase-ii-a-phase-ii-randomized-trial
#15
David O Okonkwo, Lori A Shutter, Carol Moore, Nancy R Temkin, Ava M Puccio, Christopher J Madden, Norberto Andaluz, Randall M Chesnut, M Ross Bullock, Gerald A Grant, John McGregor, Michael Weaver, Jack Jallo, Peter D LeRoux, Dick Moberg, Jason Barber, Christos Lazaridis, Ramon R Diaz-Arrastia
OBJECTIVES: A relationship between reduced brain tissue oxygenation and poor outcome following severe traumatic brain injury has been reported in observational studies. We designed a Phase II trial to assess whether a neurocritical care management protocol could improve brain tissue oxygenation levels in patients with severe traumatic brain injury and the feasibility of a Phase III efficacy study. DESIGN: Randomized prospective clinical trial. SETTING: Ten ICUs in the United States...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29028661/changes-in-viral-suppression-status-among-hiv-patients-receiving-care-united-states-2014
#16
Nicole Crepaz, Tian Tang, Gary Marks, H Irene Hall
OBJECTIVE: To examine changes in viral suppression status among HIV patients receiving care in 2014 and the extent of viral suppression among persons with infrequent care visits. METHODS: Using data reported to the National HIV Surveillance System from 33 jurisdictions with complete reporting of CD4 and viral load tests, we created four viral suppression status groups based on their first and last viral loads in 2014: both suppressed, first unsuppressed and last suppressed (improved), first suppressed and last unsuppressed (worsened), and both unsuppressed...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29028657/combinations-of-interventions-to-achieve-a-national-hiv-incidence-reduction-goal-insights-from-the-agent-based-path-2-0-model
#17
Chaitra Gopalappa, Stephanie L Sansom, Paul G Farnham, Yao-Hsuan Chen
OBJECTIVE: Analyzing HIV care service targets for achieving a national goal of a 25% reduction in annual HIV incidence and evaluating the use of annual HIV diagnoses to measure progress in incidence reduction. DESIGN: Because there are considerable interactions among HIV care services, we model the dynamics of combinations of increases in HIV care continuum targets to identify those that would achieve 25% reductions in annual incidence and diagnoses. METHODS: We used Progression and Transmission of HIV/AIDS (PATH 2...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29028642/-lost-to-follow-up-among-adult-cancer-survivors
#18
Amitoj Gill, Rohit Gosain, Shruti Bhandari, Rahul Gosain, Gurkirat Gill, Joseph Abraham, Kenneth Miller
BACKGROUND: Follow-up cancer care is important for patients who have received IV chemotherapy but some patients discontinue their care and are lost to follow-up (LFU) at the cancer center where they were treated. The purpose of this study was to determine what proportion of cancer survivors are LFU at 5 years after treatment, the timing of LFU, and the characteristics of those who do not continue survivorship care. METHODS: Adult patients with cancer who were treated with chemotherapy at a large community teaching hospital in 2006 and 2007 were identified and linked with State tumor registry data...
October 12, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29028553/a-nationwide-analysis-of-intensive-care-unit-admissions-2009-2014-the-korean-icu-national-data-kind-study
#19
Jinkyeong Park, Kyeongman Jeon, Chi Ryang Chung, Jeong Hoon Yang, Yang Hyun Cho, Joongbum Cho, Chi-Min Park, Hyejeong Park, Juhee Cho, Eliseo Guallar, Gee Young Suh
PURPOSE: To evaluate unbiased information on the characteristics, procedures, and outcomes of intensive care unit (ICU) admissions in a long-term nationwide study. MATERIALS AND METHODS: Cohort study of all ICU admissions in patients >18years of age in Korea between August 1, 2009 and September 30, 2014 (1,553,673 ICU admissions in 1,265,509 patients). RESULTS: From August 2009 to September 2014, the age-standardized ICU admission rate was 744...
September 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29028461/antibiotic-impregnated-central-venous-catheters-do-not-change-antibiotic-resistance-patterns
#20
Isaiah R Turnbull, Sara A Buckman, Christopher B Horn, Grant V Bochicchio, John E Mazuski
BACKGROUND: Antibiotic-impregnated central venous catheters (CVCs) decrease the incidence of infection in high-risk patients. However, use of these catheters carries the hypothetical risk of inducing antibiotic resistance. We hypothesized that routine use of minocycline and rifampin-impregnated catheters (MR-CVC) in a single intensive care unit (ICU) would change the resistance profile for Staphylococcus aureus. METHODS: We reviewed antibiotic susceptibilities of S...
October 13, 2017: Surgical Infections
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