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https://www.readbyqxmd.com/read/28092309/microbiota-targeted-therapies-on-the-intensive-care-unit
#1
Bastiaan W Haak, Marcel Levi, W Joost Wiersinga
PURPOSE OF REVIEW: The composition and diversity of the microbiota of the human gut, skin, and several other sites is severely deranged in critically ill patients on the ICU, and it is likely that these disruptions can negatively affect outcome. We here review new and ongoing studies that investigate the use of microbiota-targeted therapeutics in the ICU, and provide recommendations for future research. RECENT FINDINGS: Practically every intervention in the ICU as well as the physiological effects of critical illness itself can have a profound impact on the gut microbiota...
January 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28079487/adopting-universal-testing-for-hiv-in-intensive-care-for-patients-admitted-with-severe-pneumonia-results-from-our-change-in-practice
#2
Rory Sharvill, Arnold Fernandes, Kate Allen, Jeremy Astin
Early identification of HIV infection is of obvious benefit to patients' health, yet many remain unaware of their diagnosis, with detrimental consequences. Current guidelines suggest patients with pneumonia are offered an HIV test. Early diagnosis of HIV infection in critically ill patients within intensive care is vital in reducing mortality and morbidity. In 2015, we established automated HIV testing for patients with pneumonia admitted to our intensive care unit. Prior to our change in practice, our HIV testing rate in patients with pneumonia was 29% within two weeks of admission...
January 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28078948/care-seeking-for-children-with-fever-cough-or-diarrhoea-in-nepal-equity-trends-over-the-last-15-years
#3
Mats Målqvist, Chahana Singh, Ashish Kc
AIMS: Childhood illnesses such as diarrhoea and pneumonia remain major contributors to child mortality globally and need to be continually targeted in pursuit of universal health coverage. This study analyses time trends in the prevalence of fever/cough and diarrhoea in Nepal and applies an equity lens in order to identify disadvantaged groups. METHODS: Data from the Nepal Demographic Health Surveys of 2001, 2006, and 2011, together with data from the most recent Multiple Indicator Cluster Survey of 2014 performed in Nepal, were utilized for analysis...
January 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#4
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28069652/antimicrobial-susceptibility-of-pseudomonas-aeruginosa-results-from-four-years-2012-2015-of-the-international-network-for-optimal-resistance-monitoring-inform-program-in-the-united-states
#5
Helio S Sader, Michael D Huband, Mariana Castanheira, Robert K Flamm
Pseudomonas aeruginosa represents a major cause of health-care associated infections, and inappropriate initial antimicrobial therapy is associated with increased morbidity and mortality. The International Network for Optimal Resistance Monitoring (INFORM) program monitors the in vitro activity of ceftazidime-avibactam and many comparators agents. We evaluated the antimicrobial susceptibility of 7,452 P. aeruginosa isolates collected from 79 USA medical centers in 2012-2015. The isolates were collected and tested consecutively for susceptibility by broth microdilution method...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28065635/meals-enhancing-nutrition-after-discharge-findings-from-a-pilot-randomized-controlled%C3%A2-trial
#6
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/28064212/impact-of-a-critical-health-workforce-shortage-on-child-health-in-zimbabwe-a-country-case-study-on-progress-in-child-survival-2000-2013
#7
Connie A Haley, Sten H Vermund, Precious Moyo, Aaron M Kipp, Bernard Madzima, Trevor Kanyowa, Teshome Desta, Kasonde Mwinga, Marie A Brault
Despite notable progress reducing global under-five mortality rates, insufficient progress in most sub-Saharan African nations has prevented the achievement of Millennium Development Goal four (MDG#4) to reduce under-five mortality by two-thirds between 1990 and 2015. Country-level assessments of factors underlying why some African countries have not been able to achieve MDG#4 have not been published. Zimbabwe was included in a four-country study examining barriers and facilitators of under-five survival between 2000 and 2013 due to its comparatively slow progress towards MDG#4...
January 7, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28057059/invasive-pneumococcal-disease-caused-by-mucoid-serotype-3-streptococcus-pneumoniae-a-case-report-and-literature-review
#8
Naomi Sugimoto, Yuka Yamagishi, Jun Hirai, Daisuke Sakanashi, Hiroyuki Suematsu, Naoya Nishiyama, Yusuke Koizumi, Hiroshige Mikamo
BACKGROUND: Among the different serotypes of Streptococcus pneumoniae, serotype 3 has received global attention. We report the fatal case of a 76-year-old Japanese man who had an invasive pneumococcal disease associated with pneumonia caused by serotype 3 S. pneumoniae. CASE PRESENTATION: The patient had a history of hypertension, laryngeal cancer, chronic obstructive pulmonary disease, and type 2 diabetes mellitus. Following a cerebral arteriovenous malformation hemorrhage, he underwent surgery to remove the hematoma and began rehabilitation...
January 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28051232/epidemiology-of-nosocomial-infections-about-70-cases
#9
Mohamed Hedfi, Hassen Khouni, Youssra Massoudi, Cherif Abdelhedi, Karim Sassi, Adnen Chouchen
Background - The infections associated with care (IAS) constitute a major public health problem by the morbi- mortality than they generate as well as by their cost to support. The prevention of these infections has become a priority for several years everywhere in the world and in the occurrence in Tunisia. Aim - The purpose of our study is to assess the prevalence of nosocomial infections as well as develop their microbiologic  profiles in the different departments of  the hospital of FSI  Marsa Tunisia and try to highlight the risk factors that can influence these infections Methods - It was a retrospective study about  patients with noscomila infection who were admitted in the different care unit of the Hospital of FSI  Marsa and this on a period of 6 years from 1 January 2009 to 31 December 2014 Results - We have identified seventy(70) patients having contracted a nososcomial infection during the period of study for 24600 hospital admission, with a prevalence rate of 0...
July 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#10
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28050458/congenital-cystic-adenomatoid-malformation-a-tertiary-care-hospital-experience
#11
Asmita Anilkumar Mehta, Naveen Viswanathan, Anil Kumar Vasudevan, Roopa Paulose, Mohan Abraham
INTRODUCTION: Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in lung development between 4(th) and 7(th) week of fetal life. AIM: The present study was conducted to assess the clinical and radiological profile and also to study the role of surgical intervention in patients with CCAM...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#12
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
January 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28043925/fatal-community-acquired-ribotype-002-clostridium-difficile-bacteremia
#13
Nicolas Dauby, Agnès Libois, Johan Van Broeck, Michel Delmée, Olivier Vandenberg, Delphine Martiny
Extra-colonic infections, and especially bacteremia, are infrequent manifestations of Clostridium difficile infection. C. difficile bacteremia is generally health-care associated and polymicrobial. We report the case of a patient on hunger strike that presented a C. difficile colitis and mono-microbial bacteremia on its admission to the hospital. Multilocus variable number tandem repeat analysis of stool and blood isolates indicated clonality. The strain was characterized as a ribotype 002, an emerging ribotype previously associated with high fatality rate...
December 30, 2016: Anaerobe
https://www.readbyqxmd.com/read/28043625/pulmonary-infections-after-tuberculosis
#14
Kauser Jabeen
AIMS AND OBJECTIVE: Despite effective treatment of pulmonary tuberculosis (TB) patients, destruction of lung parenchyma may lead to complications including repeated infections. These infections are often misdiagnosed or wrongly identified as TB recurrence, and hence are not treated effectively. The frequency and severity of these infections vary with the extent of damage, and are much more prominent in patients with post-TB bronchiectasis and fibrocavitary diseases. This presentation will focus on the epidemiology, treatment, and management of post-TB infections and challenges, and the impact of these infections on public health in high-TB-burden countries...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28036311/etiological-profile-of-early-neonatal-bacterial-sepsis-by-multiplex-qpcr
#15
Walter P Silva-Junior, Almir S Martins, Paula C N Xavier, Kelly L A Appel, Silvio A Oliveira Junior, Durval B Palhares
INTRODUCTION: Given the major impact in terms of morbidity and mortality that episodes of early neonatal sepsis (ENS) have on both newborns and health systems, this study aimed to identify the etiological profile of early neonatal bacterial sepsis by a multiplex quantitative real-time polymerase chain reaction (qPCR). METHODOLOGY: Blood samples from newborns diagnosed with clinical ENS and hospitalized in neonatal intensive care units (NICUs) were collected and analyzed using the multiplex qPCR method to detect Streptococcus agalactiae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter sp...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28033143/probiotics-for-trauma-patients-should-we-be-taking-a-precautionary-approach
#16
Heather A Vitko, L Kathleen Sekula, Martin A Schreiber
The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28024302/readmission-rates-after-passage-of-the-hospital-readmissions-reduction-program-a-pre-post-analysis
#17
Jason H Wasfy, Corwin Matthew Zigler, Christine Choirat, Yun Wang, Francesca Dominici, Robert W Yeh
Background: Whether hospitals with the highest risk-standardized readmission rates (RSRRs) subsequently experienced the greatest improvement after passage of the Medicare Hospital Readmissions Reduction Program (HRRP) is unknown. Objective: To evaluate whether passage of the HRRP was followed by acceleration in improvement in 30-day RSRRs after hospitalizations for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia and whether the lowest-performing hospitals had faster acceleration in improvement after passage of the law than hospitals that were already performing well...
December 27, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28013258/epidemiology-of-carbapenem-resistant-klebsiella-pneumoniae-in-a-network-of-long-term-acute-care-hospitals
#18
Jennifer H Han, Ellie J C Goldstein, Jacqueleen Wise, Warren B Bilker, Pam Tolomeo, Ebbing Lautenbach
BACKGROUND: The rapid emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a major public health threat, including in the long-term acute care hospital (LTACH) setting. The objective of this study was to describe the epidemiologic characteristics of CRKP in a network of United States LTACHs. METHODS: An observational study was performed among 64 LTACHs from January 2014 to March 2015. Clinical cultures were included, with the first CRKP isolate recovered from each patient per study quarter evaluated...
December 24, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28009318/indicators-of-phagocytic-component-and-secretory-iga-in-children-with-bronchial-asthma-secondary-to-undifferentiated-connective-tissue-dysplasia
#19
V Semianchuk, L Haridzhuk, O Bobrykovych
Its aim is to improve the diagnostics and treatment of Bronchial Asthma. There were examined 93 children with bronchial asthma at the age of 6-10 years. All patients were diagnosed with partially controlled or uncontrolled clinical course of bronchial asthma and manifestations of undifferentiated connective tissue dysplasia. The control group included 21 practically healthy children of the same age. The diagnosis of bronchial asthma was made, and the clinical course was determined in accordance with the criteria approved by the Order of Ministry of Health of Ukraine of October 08, 2013 No 868 "Unified clinical protocol of primary, secondary (specialized) medical care "Bronchial Asthma in Children" and GINA criteria (updated in 2015)...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/28008700/knowledge-level-of-nurses-in-jordan-on-ventilator-associated-pneumonia-and-preventive-measures
#20
Zeinab M Hassan, Moayad A Wahsheh
BACKGROUND: Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have demonstrated an effect of reducing the incidence of this infection. AIMS: To identify the level of nurses' knowledge of ventilator-associated pneumonia and prevention measures before an educational programme, identify the level of nurses' knowledge on ventilator-associated pneumonia and prevention post an educational programme and identify the reasons for not applying ventilator-associated pneumonia prevention measures among nurses in Jordan...
December 22, 2016: Nursing in Critical Care
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