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https://www.readbyqxmd.com/read/28735313/early-kpc-producing-klebsiella-pneumoniae-bacteremia-among-intensive-care-unit-patients-non-colonized-upon-admission
#1
Matthaios Papadimitriou-Olivgeris, Fotini Fligou, Iris Spiliopoulou, Christina Bartzavali, Vasiliki Dodou, Sophia Vamvakopoulou, Kyriaki Koutsileou, Anastasia Zotou, Evangelos D Anastassiou, Myrto Christofidou, Markos Marangos
Among 140 patients colonized by KPC-producing Klebsiella pneumoniae (KPC-Kp) between fourth and seventh day of Intensive Care Unit stay, 24 developed bacteraemia immediately after colonization. Colistin-resistance of the colonizing isolate was the factor significantly associated with early KPC-Kp bacteraemia (P < 0.001; OR 6.6, 95% CI 2.4-18.4), a worrisome finding since infections by colistin-resistant isolates is associated with increased mortality due to limited remaining therapeutic options.
July 6, 2017: Polish Journal of Microbiology
https://www.readbyqxmd.com/read/28735131/mini-craniotomy-under-local-anesthesia-for-chronic-subdural-hematoma-an-effective-choice-for-elderly-and-for-patients-in-a-resource-strained-environment
#2
Shaikh Danish Mahmood, Muhammad Waqas, Mirza Z Baig, Aneela Darbar
BACKGROUND: Mini craniotomy for chronic subdural hematoma (CSDH) is associated with lower recurrence rates. However, the procedure is mostly performed under general anesthesia (GA) and therefore frequently requires intensive care unit (ICU) facility, especially in the elderly population. Due to unavailability of ICU beds, and to avoid GA, we started to perform this procedure under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735120/outpatient-lumbar-microdiscectomy-in-france-from-an-economic-imperative-to-a-clinical-standard-an-observational-study-of-201-cases
#3
Bertrand Debono, Pascal Sabatier, Valérie Garnault, Olivier Hamel, Philippe Bousquet, Jean-Paul Lescure, Jean-Yves Plas
PURPOSE: The outpatient lumbar discectomy procedures have been established for more than two decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medico-economic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution. METHODS: Over a three year period, 201 patients met the criteria for ambulatory lumbar microdiscectomy...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735030/effect-of-bosentan-therapy-in-persistent-pulmonary-hypertension-of-the-newborn
#4
Gunlawadee Maneenil, Anucha Thatrimontrichai, Waricha Janjindamai, Supaporn Dissaneevate
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) contributes to neonatal hypoxemia and is associated with a high mortality. Some PPHN patients are unresponsive to inhaled nitric oxide (iNO). Bosentan, an oral endothelin-1 receptor antagonist, reduces pulmonary vascular resistance and hence may play a role in the treatment of PPHN. METHODS: A retrospective medical records review was performed in newborns who received oral bosentan as an adjunctive therapy for treatment of PPHN between January 2013 and February 2016 at the neonatal intensive care unit of Songklanagarind Hospital...
July 11, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28734995/senior-oral-and-maxillofacial-surgery-resident-confidence-in-performing-invasive-temporomandibular-joint-procedures
#5
Mohmedvasim Momin, Michael Miloro, Louis G Mercuri, Alexander Munaretto, Michael R Markiewicz
PURPOSE: The purpose of this study was to evaluate the level of confidence that senior-level oral and maxillofacial surgery (OMS) residents have in the management of temporomandibular joint (TMJ) disorders, determine their exposure to various invasive TMJ procedures during training, and assess their confidence in performing those procedures on completion of residency. MATERIALS AND METHODS: A questionnaire was designed, and a link to a University of Illinois at Chicago Qualtrics Survey platform (Qualtrics, Provo, UT) was e-mailed to all program directors at Commission on Dental Accreditation-accredited OMS training programs in the United States...
June 30, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28734823/evaluation-of-early-administration-of-simvastatin-in-the-prevention-and-treatment-of-delirium-in-critically-ill-patients-undergoing-mechanical-ventilation-modus-a-randomised-double-blind-placebo-controlled-trial
#6
Valerie J Page, Annalisa Casarin, E Wesley Ely, Xiao Bei Zhao, Cliona McDowell, Lynn Murphy, Daniel F McAuley
BACKGROUND: Delirium in critically ill patients is associated with poor clinical outcomes. Neuroinflammation might be an important mechanism in the pathogenesis of delirium, and since simvastatin has anti-inflammatory properties it might reduce delirium. We aimed to establish whether early treatment with simvastatin would decrease the time that survivors of critical illness spent in delirium or coma. METHODS: We undertook this randomised, double-blind, placebo-controlled trial in a general adult intensive care unit (ICU) in Watford General Hospital (Watford, UK)...
July 19, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28734809/-severe-poisoning-by-traditional-medication-in-the-newborn
#7
A Oulmaati, F Hmami, S Achour, A Bouharrou
The use of traditional products for therapeutic purposes in the newborn cause many cases of severe poisoning, especially in newborns. The aim of this study was to identify the main medicinal plants causing poisoning and emphasize the seriousness of poisonous plants. We report a series of eight newborns admitted for intake of poisonous medicinal plants admitted to the neonatal unit and neonatal intensive care unit at the Fez (Morocco) Hassan II University Hospital in 2014. The reasons for use were dominated by the infant's refusing to suckle...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28734807/-a-survey-on-premedication-prior-to-intubation-in-very-preterm-infants-28-32wg-with-respiratory-distress-syndrome-in-french-neonatal-intensive-care-units
#8
E Boiron, E Merlot, G Loron, X Durrmeyer, E Guyot
INTRODUCTION/OBJECTIVES: Tracheal intubation is a painful procedure for which the routine use of analgesia is recommended. However, the use of premedication for intubation is not yet generalized and there is great diversity in the drugs used. The main objective of this study was to describe the frequency of premedication use in preterm neonates aged between 28 and 32weeks of gestation, intubated for respiratory distress syndrome. Secondary objectives were to describe the existence of a written protocol, its influence on the frequency of premedication and the drugs used...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28734798/barriers-to-conducting-ambulatory-and-home-blood-pressure-monitoring-during-hypertension-screening-in-the-united-states
#9
Ian M Kronish, Shia Kent, Nathalie Moise, Daichi Shimbo, Monika M Safford, Robert E Kynerd, Ronan O'Beirne, Alexandra Sullivan, Paul Muntner
In 2015, the US Preventive Services Task Force updated their hypertension recommendations to advise that adults with elevated office blood pressure (BP) undergo out-of-office BP measurement to exclude white coat hypertension before diagnosis. Our goal was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. We enrolled 63 primary care providers into nominal group panels in which participants iteratively listed and ranked barriers to ambulatory and home BP monitoring...
July 6, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28734712/-candidemia-in-pediatrics-species-distribution-and-antifungal-susceptibility
#10
Luciana B Guzzetti, Cecilia M Vescina, M Florencia Gil, Blanca M Gatti
Serious infections caused by Candida yeasts are frequent in the hospital population. Due to differences in species distribution and antifungal susceptibility testing depending on the geographic area and the type of patient, it is important to study the epidemiology of each institution. For this purpose, we conducted a retrospective, descriptive study on the occurrence of candidemia in the Children's Hospital "Superiora Sor María Ludovica" of the city of La Plata. In a 6-year period (2010-2015), 177 candidemia episodes were recorded...
July 19, 2017: Revista Argentina de Microbiología
https://www.readbyqxmd.com/read/28734656/patterns-of-emergency-department-care-for-newly-diagnosed-immune-thrombocytopenia-in-united-states-children-s-hospitals
#11
LaQuita Jones, Terah Koch, Joseph Stanek, Sarah H O'Brien
We used the Pediatric Health Information Systems database to ascertain treatment patterns of immune thrombocytopenia across the US. Despite the recently published guidelines by the American Society of Hematology, most patients are still being hospitalized for immune thrombocytopenia, even in the absence of documented bleeding symptoms.
July 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28734637/-asthma-and-heroin-use
#12
Michel Underner, Jean Perriot, Gérard Peiffer, Nematollah Jaafari
INTRODUCTION: Heroin use can be responsible for many respiratory complications including asthma. OBJECTIVES: Systematic literature review of data on asthma in heroin users. DOCUMENTARY SOURCES: Medline(®), on the period 1980-2017 with the following keywords: keywords: "asthma" or "bronchospasm" and "heroin" or "opiate" or "opiates", limits "title/abstract"; the selected languages were English or French. Among 97 articles, 67 abstracts have given use to a dual reading to select 23 studies...
July 19, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28734630/management-of-an-acinetobacter-baumannii-outbreak-in-an-intensive-care-unit
#13
M Tanguy, A Kouatchet, B Tanguy, É Pichard, S Fanello, M-L Joly-Guillou
INTRODUCTION: Acinetobacter baumannii is a ubiquitous pathogen resistant to desiccation and responsible for healthcare-associated infections (HAI), especially in intensive care units (ICU) where it is responsible for 5-10% of HAIs. An A. baumannii outbreak occurred in the ICU of the University Hospital of Angers, France. OBJECTIVES: To describe the A. baumannii outbreak and to evaluate the control measures taken. The secondary objective was to evaluate the impact of the electronic alert system on the incidence of multidrug resistance to antibiotics...
July 19, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28734547/management-of-hemostatic-disorders-in-patients-with-advanced-liver-disease-admitted-to-an-intensive-care-unit
#14
REVIEW
Ton Lisman, William Bernal
Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease...
June 23, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28734504/-relationship-between-family-variables-and-conjugal-adjustment
#15
Nerea Jiménez-Picón, Joaquín-Salvador Lima-Rodríguez, Marta Lima-Serrano
OBJECTIVE: To determine whether family variables, such as type of relationship, years of marriage, existence of offspring, number of members of family, stage of family life cycle, transition between stages, perceived social support, and/or stressful life events are related to conjugal adjustment. DESIGN: A cross-sectional and correlational study using questionnaires. LOCATION: Primary care and hospital units of selected centres in the province of Seville, Spain...
July 19, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28734488/clinical-fellowship-for-an-innovative-integrated-bsn-phd-program-an-academic-and-practice-partnership
#16
Madelyne Z Greene, Mary Kate FitzPatrick, Jean Romano, Linda H Aiken, Therese S Richmond
Opportunities for research-focused doctoral education must be available to nurses early in their careers in order to ensure the further development of nursing science. Early entry into the research doctorate through an integrated BSN-PhD program is one innovative approach. This approach highlights the value of integrating post-licensure clinical training into the doctoral curriculum. To better prepare innovative nurse scientists early in their careers we developed a clinical nurse fellowship within an integrated BSN-PhD program in partnership with an affiliated health system...
July 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28734479/the-internal-medicine-of-the-21st-century-organizational-and-operational-standards
#17
E Casariego-Vales, A Zapatero-Gaviria, F J Elola-Somoza
The Spanish Society of Internal Medicine has developed a consensus document on the standards and recommendations that they consider essential to the organisation of internal medicine units for conducting their activities efficiently and with high quality. We defined 3 groups of key processes: the care of acutely ill adult patients, the comprehensive care of complex chronic patients and the examination of a patient with a difficult diagnosis and no organ-specific disease. As support processes, we identified the structure and operation of the Internal Medicine units...
July 19, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28734195/implementation-of-psychological-clinical-trials-in-epilepsy-review-and-guide
#18
REVIEW
Avani C Modi, Janelle Wagner, Aimee W Smith, Tanja S Kellermann, Rosa Michaelis
The International League Against Epilepsy (ILAE) Neuropsychiatry commission and United States Institute of Medicine report both identified cognitive and psychological comorbidities as a significant issue for individuals with epilepsy, with rates as high as 60%. However, there is a paucity of evidence-based treatments for many psychological conditions (e.g., learning disorders, cognitive disorders, behavioral disorders). Because of inherent challenges in the implementation of psychological therapy trials and specific considerations for the population with epilepsy, the focus of the current review was to provide guidance and recommendations to conduct psychological trials for individuals with epilepsy...
July 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28734109/the-cost-of-oropharyngeal-cancer-in-england-a-retrospective-hospital-data-analysis
#19
Sam T Keeping, Michael J Tempest, Stephanie J Stephens, Stuart M Carroll, Richard Simcock, Terence M Jones, Richard Shaw
OBJECTIVES: To estimate the total costs of treating head and neck cancers, specifically oropharyngeal, laryngeal and oral cavity cancer, in secondary care facilities in England during the period 2006/2007 to 2010/2011. DESIGN: Patient records were extracted from an English hospital database to estimate the number of patients treated for oropharyngeal, laryngeal and oral cavity cancer in England. Identified resource use was linked to published United Kingdom cost estimates to quantify the reimbursement of treatment through the Payment by Results system...
July 22, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28734046/effect-of-a-community-based-service-learning-experience-in-geriatrics-on-internal-medicine-residents-and-community-participants
#20
Rachel K Miller, Jennifer Michener, Phyllis Yang, Karen Goldstein, Jennine Groce-Martin, Gala True, Jerry Johnson
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources...
July 22, 2017: Journal of the American Geriatrics Society
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