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https://www.readbyqxmd.com/read/28440855/accuracy-of-current-diagnostic-criteria-for-acute-bacterial-infection-in-older-adults-in-the-emergency-department
#1
Jeffrey M Caterino, Robert Leininger, David M Kline, Lauren T Southerland, Salman Khaliqdina, Christopher W Baugh, Daniel J Pallin, Kurt B Stevenson
OBJECTIVES: To compare the accuracy of the Loeb criteria, emergency department (ED) physicians' diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review. DESIGN: Prospective, observational study. SETTING: Urban, tertiary-care ED. PARTICIPANTS: Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent...
April 25, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28440531/initial-polish-experience-of-flexible-19-gauge-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#2
Maciej Gnass, Joanna Sola, Anna Filarecka, Stanisław Orzechowski, Piotr Kocoń, Monika Pasieka-Lis, Juliusz Pankowski, Lucyna Rudnicka, Jerzy Soja, Artur Szlubowski
INTRODUCTION: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopist's feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28439949/weight-gain-and-supplemental-o2-risk-factors-during-the-hematopoietic-cell-transplant-admission-in-pediatric-patients
#3
Courtney M Rowan, Mara E Nitu, Elizabeth A S Moser, Nancy L Swigonski, Jamie L Renbarger
BACKGROUND: Respiratory failure in the pediatric hematopoietic cell transplant (HCT) recipient is the leading cause for admission to the intensive care unit and carries a high mortality rate. The objective of this study is to investigate the association of clinical risk factors with the development of respiratory failure in the pediatric allogeneic HCT recipient. PROCEDURES: This is a single-center, retrospective review of allogeneic pediatric HCT from 2008 to 2014...
April 25, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28438507/cardiothoracic-transplant-recipient-mycoplasma-hominis-an-uncommon-infection-with-probable-donor-transmission
#4
Rahul Sampath, Robin Patel, Scott A Cunningham, Sana Arif, Richard C Daly, Andrew D Badley, Mark E Wylam
The role of infection with Mycoplasma hominis following cardiothoracic organ transplantation and its source of transmission have not been well-defined. Here, we identify and describe infection with M. hominis in patients following cardiothoracic organ transplantation after reviewing all cardiothoracic transplantations performed at our center between 1998 and July 2015. We found seven previously unreported cases of M. hominis culture positive infection all of whom presented with pleuritis, surgical site infection, and/or mediastinitis...
April 19, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28438499/rationalizing-endpoints-for-prospective-studies-of-pulmonary-exacerbation-treatment-response-in-cystic-fibrosis
#5
D R VanDevanter, S L Heltshe, J Spahr, V V Beckett, C L Daines, E C Dasenbrook, R L Gibson, R Jain, D B Sanders, C H Goss, P A Flume
BACKGROUND: Given the variability in pulmonary exacerbation (PEx) management within and between Cystic Fibrosis (CF) Care Centers, it is possible that some approaches may be superior to others. A challenge with comparing different PEx management approaches is lack of a community consensus with respect to treatment-response metrics. In this analysis, we assess the feasibility of using different response metrics in prospective randomized studies comparing PEx treatment protocols. METHODS: Response parameters were compiled from the recent STOP (Standardized Treatment of PEx) feasibility study...
April 21, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28438451/common-medical-comorbidities-correlated-with-poor-outcomes-in-hip-periprosthetic-infection
#6
Daniel J Cunningham, Joseph J Kavolus, Michael P Bolognesi, Samuel S Wellman, Thorsten M Seyler
BACKGROUND: Periprosthetic infection has been linked to risk factors such as diabetes, obesity, and smoking among others. This study examined the relationship between common patient comorbidities and hip periprosthetic infection outcomes. METHODS: We retrospectively reviewed the records of 149 culture-positive periprosthetic hip infections at our tertiary care center that underwent treatment between 2005 and 2015. Baseline characteristics and common comorbidities were analyzed with relation to rates of successfully treated infection, total surgeries for infection, and cumulative length of hospitalization using multivariate analysis...
March 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437538/effects-of-diagnosis-by-newborn-screening-for-cystic-fibrosis-on-weight-and-length-in-the-first-year-of-life
#7
Daniel H Leung, Sonya L Heltshe, Drucy Borowitz, Daniel Gelfond, Margaret Kloster, James E Heubi, Michael Stalvey, Bonnie W Ramsey
Importance: Since the implementation of universal newborn screening (NBS) for cystic fibrosis (CF), the timing and magnitude of growth deficiency or its association with correlates of disease among infants with CF who underwent NBS has not been well described. Objective: To examine incremental weight gain, linear growth, and clinical features in the first year of life among infants with CF who underwent NBS. Design, Setting, and Participants: The Baby Observational and Nutrition Study (BONUS), a multicenter, longitudinal, observational cohort study, was conducted during regular CF clinic visits in the first 12 months of life at 28 US Cystic Fibrosis Foundation-accredited Care Centers from January 7, 2012, through May 31, 2015...
April 24, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28436174/endobronchial-and-transbronchial-biopsy-experience-a-united-kingdom-survey
#8
REVIEW
Janet Fallon, Andrew R L Medford
BACKGROUND: Trainees are performing fewer bronchoscopies as a result of the increased use of endobronchial ultrasound-guided transbronchial needle aspiration. Workforce planning and changes in trainee working patterns may also have compounded this situation. We investigated current trends in endobronchial biopsy (EBB) and transbronchial biopsy (TBB) training and competency in respiratory trainees and consultants across the United Kingdom. METHODS: We performed a national survey and received 131 online responses from 58 consultants and 73 registrars across 13 United Kingdom deaneries...
April 24, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28433732/the-clinical-significance-of-an-estimated-fetal-weight-below-the-10th-centile-a-comparison-of-outcomes-between-5th-versus-5th-9th-centile
#9
Malgorzata Mlynarczyk, Suneet P Chauhan, Hind A Baydoun, Catherine M Wilkes, Kimberly R Earhart, Yili Zhao, Christopher Goodier, Eugene Chang, Nicole M Lee Plenty, E Kaitlyn Mize, Michelle Owens, Shilpa Babbar, Dev Maulik, Emily DeFranco, David McKinney, Alfred Z Abuhamad
BACKGROUND: The association between small for gestational age (SGA; birth weight < 10(th) centile for gestational age) and neonatal morbidity is well established. Yet there is a paucity of data on the relationship between suspected SGA (sonographic estimated fetal weight <10(th) centile), at two thresholds and subsequent neonatal morbidity. OBJECTIVE: The objective of this study was to determine the relationship between sonographic estimated fetal weight (SEFW) < 5(th) centile versus 5-9(th) centile and neonatal morbidity...
April 19, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28433385/perioperative-risks-of-narcolepsy-in-patients-undergoing-general-anesthesia-a-case-control-study
#10
Alexandre N Cavalcante, Ryan E Hofer, Maja Tippmann-Peikert, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To compare the perioperative outcomes between patients with narcolepsy and matched controls undergoing anesthetic management. DESIGN: Retrospective 2:1 matched study design. SETTING: Large tertiary medical center. PATIENTS: Narcoleptic patients who underwent general anesthesia from January 1, 2011, through September 30, 2015, were matched with controls by age, sex, and type and year of surgery. MEASUREMENTS: Medical records were reviewed for episodes of respiratory depression during phase I recovery and for other meaningful perioperative outcomes...
April 19, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28432267/assessment-of-lung-function-in-a-large-cohort-of-patients-with-acromegaly
#11
Sylvere Störmann, Bodo Gutt, Josefine Roemmler-Zehrer, Martin Bidlingmaier, Rudolf Maria Huber, Jochen Schopohl, Matthias Angstwurm
OBJECTIVE: Acromegaly is associated with increased mortality due to respiratory disease. To date, lung function in patients with acromegaly has only been assessed in small studies, with contradicting results. We assessed lung function parameters in a large cohort of patients with acromegaly. DESIGN: Lung function of acromegaly patients was prospectively assessed using spirometry, blood gas analysis and body plethysmography. Biochemical indicators of acromegaly were assessed through measurement of growth hormone and IGF-I levels...
April 21, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28431817/pneumococcal-carriage-among-children-after-four-years-of-routine-10-valent-pneumococcal-conjugate-vaccine-use-in-brazil-the-emergence-of-multidrug-resistant-serotype-6c
#12
Felipe P G Neves, Nayara T Cardoso, Robert E Snyder, Mariel A Marlow, Claudete A A Cardoso, Lúcia M Teixeira, Lee W Riley
BACKGROUND: In 2010, the 10-valent pneumococcal conjugate vaccine (PCV10) was introduced free of charge in Brazil as part of the public immunization program. Here we investigated the carriage prevalence, colonization risk factors, capsular types, and antimicrobial resistance among pneumococcal isolates obtained from children in Brazil four years after routine PCV10 use. METHODS: Between September and December 2014, we conducted a cross-sectional study among children<6years old who attended one public and two private clinics in Niterói, RJ, Brazil to evaluate pneumococcal nasopharyngeal carriage...
April 18, 2017: Vaccine
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#13
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#14
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#15
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28426726/vibrotactile-stimulation-a-non-pharmacological-intervention-for-opioid-exposed-newborns
#16
Ian Zuzarte, Premananda Indic, Bruce Barton, David Paydarfar, Francis Bednarek, Elisabeth Bloch-Salisbury
OBJECTIVE: To examine the therapeutic potential of stochastic vibrotactile stimulation (SVS) as a complementary non-pharmacological intervention for withdrawal in opioid-exposed newborns. STUDY DESIGN: A prospective, within-subjects single-center study was conducted in 26 opioid-exposed newborns (>37 weeks; 16 male) hospitalized since birth and treated pharmacologically for Neonatal Abstinence Syndrome. A specially-constructed mattress delivered low-level SVS (30-60Hz, 10-12μm RMS), alternated in 30-min intervals between continuous vibration (ON) and no vibration (OFF) over a 6-8 hr session...
2017: PloS One
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-vs-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#17
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#18
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28424884/principle-and-basic-property-of-the-sequential-flow-pump
#19
Shintaro Hara, Erina Maeno, Xinyang Li, Terumi Yurimoto, Takashi Isoyama, Itsuro Saito, Toshiya Ono, Yusuke Abe
In the emergency care field, early treatment of acute heart or respiratory failure has been a global concern. In severe cases, patients are frequently required to be on an extracorporeal membrane oxygenator (ECMO) life support. To make the ECMO system more compact and portable, we proposed a sequential flow-type centrifugal pump named the sequential flow pump (SFP). In this study, principle and basic properties of this novel blood pump were examined by computational fluid dynamic (CFD) analysis and an experimental model...
April 19, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28424245/oral-nutrition-in-children-with-bronchiolitis-on-high-flow-nasal-cannula-is-well-tolerated
#20
Anthony Alexander Sochet, Jessica Ann McGee, Tessie Wazeerah October
OBJECTIVES: To determine the incidence of aspiration-related respiratory failure and nutrition interruptions in children with bronchiolitis on high-flow nasal cannula (HFNC) receiving enteral nutrition. METHODS: We performed a single-center, prospective, observational cohort study within a 313-bed tertiary medical center from January through December 2015. We included term children 1 month to 2 years of age without comorbid bacterial pneumonia or chronic medical conditions who were diagnosed with bronchiolitis while receiving HFNC and enteral nutrition...
April 19, 2017: Hospital Pediatrics
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