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https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#1
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28632826/-pyogenic-liver-abscess-in-children-clinical-experience-in-a-pediatric-reference-center
#2
Carolina Carballo, Claudia Cazes, Mariana Matsuda, M Laura Praino, Noemí Rivas, Eduardo López
INTRODUCTION: Liver abscess is a serious and an uncommon pediatric disease. OBJECTIVE AND METHOD: Description of 20 pediatric patients with liver abscess admitted in "Ricardo Gutierrez" Children's Hospital, a Tertiary Reference Center of Buenos Aires, between 2009 and 2015. RESULTS: The hospitalization rate was 35/100.000 admissions. Median age was 5 years old, male/female ratio 4/1. Five patients (25%) had predisposing factors. Median days at diagnosis were 12...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632754/permissive-hypercapnia-for-severe-acute-respiratory-distress-syndrome-in-immunocompromised-children-a-single-center-experience
#3
Hans Fuchs, Nicola Rossmann, Manuel B Schmid, Manfred Hoenig, Ulrich Thome, Benjamin Mayer, Daniel Klotz, Helmut D Hummler
BACKGROUND: Controlled hypoventilation while accepting hypercapnia has been advocated to reduce ventilator-induced lung injury. The aim of the study was to analyze outcomes of a cohort of immunocompromised children with acute respiratory distress syndrome (ARDS) ventilated with a strategy of stepwise increasing PCO2 targets up to 140 mm Hg. METHODS: Retrospective analysis of outcomes of a cohort of children with oncologic disease or after stem cell transplantation and severe respiratory failure in comparison with a historical control cohort...
2017: PloS One
https://www.readbyqxmd.com/read/28632529/respiratory-system-mechanics-during-low-versus-high-positive-end-expiratory-pressure-in-open-abdominal-surgery-a-substudy-of-provhilo-randomized-controlled-trial
#4
Davide D'Antini, Robert Huhle, Jacob Herrmann, Demet S Sulemanji, Jun Oto, Pasquale Raimondo, Lucia Mirabella, Sabrine N T Hemmes, Marcus J Schultz, Paolo Pelosi, David W Kaczka, Marcos Francisco Vidal Melo, Marcelo Gama de Abreu, Gilda Cinnella
BACKGROUND: In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D)...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631174/studies-of-the-interaction-of-influenza-virus-rna-polymerase-pan-with-endonuclease-inhibitors
#5
Li-Hua Dong, Xiao-Rong Cao
Influenza virus is a major causative agent of respiratory viral infections, and RNA polymerase catalyzes its replication and transcription activities in infected cell nuclei. Since it is highly conserved in all virus strains, RNA polymerase becomes a key target of anti-influenza virus agents. Although experimental studies have revealed the good inhibitory activity of endonuclease inhibitors to RNA polymerase, the mechanism is still unclear. In this study, the docking and molecular dynamics simulations have been performed to explore the interaction of three kinds of endonuclease inhibitors with the subunit (PAN) of RNA polymerase...
June 19, 2017: Interdisciplinary Sciences, Computational Life Sciences
https://www.readbyqxmd.com/read/28629318/the-effect-of-a-daily-application-of-a-0-05-chlorhexidine-oral-rinse-solution-on-the-incidence-of-aspiration-pneumonia-in-nursing-home-residents-a-multicenter-study
#6
Vanessa R Y Hollaar, Gert-Jan van der Putten, Claar D van der Maarel-Wierink, Ewald M Bronkhorst, Bert J M de Swart, Nico H J Creugers
BACKGROUND: Dysphagia and potential respiratory pathogens in the oral biofilm are risk factors for aspiration pneumonia in nursing home residents. The aim of the study was to examine if the daily application of 0.05% chlorhexidine oral rinse solution is effective in reducing the incidence of aspiration pneumonia in nursing home residents with dysphagia. Associations between background variables (age, gender, dysphagia severity, care dependency, medication use, number of medical diagnoses, teeth and dental implants, and wearing removable dentures) and the incidence of aspiration pneumonia were also examined...
June 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28628847/the-importance-of-declining-insulin-requirements-during-pregnancy-in-patients-with-pre-gestational-gestational-diabetes-mellitus
#7
Maya Ram, Larissa Feinmesser, Shiri Shinar, Sharon Maslovitz
OBJECTIVE: In patients with pre-gestational and gestational diabetes mellitus (GDM), insulin requirements often increase during the third trimester of pregnancy in order to maintain proper glycemic control. However, a fraction of patients demonstrate a significant decrease in insulin requirements in late gestation. We aimed to evaluate the clinical significance of decreasing insulin requirements in patients with pre-gestational diabetes and GDM with respect to fetal wellbeing and pregnancy outcome...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28628546/the-impact-of-multiple-viral-respiratory-infections-on-outcomes-for-critically-ill-children
#8
Jigar C Chauhan, Nicholas B Slamon
OBJECTIVE: Advances in molecular diagnosis have led to increased testing for single and multiviral respiratory infection in routine clinical practice. This study compares outcomes between single and multiviral respiratory infections in children younger than 5 years old admitted to the PICU with respiratory failure. DESIGN: Retrospective, single-center, cohort study. SETTING: Tertiary-care, freestanding children's hospital. PATIENTS: Children younger than 5 years old admitted to the PICU with respiratory failure and positive respiratory molecular panel...
June 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28627978/scarf-pin-related-hijab-syndrome-a-new-name-for-an-unusual-type-of-foreign-body-aspiration
#9
Aram Baram, Fahmi H Kakamad, Delan Ahmed Bakir
Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28626847/injury-intense-dust-exposure-and-chronic-disease-among-survivors-of-the-world-trade-center-terrorist-attacks-of-september-11-2001
#10
Howard E Alper, Shengchao Yu, Steven D Stellman, Robert M Brackbill
BACKGROUND: The World Trade Center attack of September 11, 2001 in New York City (9/11) exposed thousands of people to intense concentrations of hazardous materials that have resulted in reports of increased levels of asthma, heart disease, diabetes, and other chronic diseases along with psychological illnesses such as post-traumatic stress disorder (PTSD). Few studies have discriminated between health consequences of immediate (short-term or acute) intense exposures versus chronic residential or workplace exposures...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28626738/streptococcus-pneumoniae-serotype-prevalence-and-antibiotic-resistance-among-young-children-with-invasive-pneumococcal-disease-experience-from-a-tertiary-care-center-in-south-india
#11
Savitha Nagaraj, Bhuvanesh Sukhlal Kalal, Anand Manoharan, Anita Shet
INTRODUCTION: We performed a study to describe the clinical profile, antimicrobial susceptibility and prevalent serotypes of pneumococcal isolates from children with suspected invasive pneumococcal disease (IPD) admitted to a tertiary care hospital in South India. METHODS: Hospitalized children, ≤ 5 years with fever (>38 °C); increased respiratory rate or neurological symptoms were recruited, (as part of the Alliance for Surveillance of Invasive Pneumococci - ASIP - project) from January 2011 to March 2013...
June 2017: Germs
https://www.readbyqxmd.com/read/28624541/the-high-prevalence-and-clinical-socio-demographic-correlates-of-miscarriages-among-flight-attendants
#12
Bettina Heidecker, Rachel Maureen Spencer, Victoria Hayes, Sarah Hall, Nisha Parikh, Eveline Oestreicher Stock, Rita Redberg
BACKGROUND: There are many occupational health hazards associated with long hours of air travel including cosmic radiation exposure, circadian rhythm disruptions and secondhand smoke exposure prior, for flight attendants who flew prior to smoking bans initiated in the 90s. Previous studies in flight attendants have found increased incidence of breast cancer and melanoma. However, there is little information on the relationship of airline travel and reproductive health in flight attendants...
June 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28624095/fontan-circulation-over-time
#13
Djoeke Wolff, Joost P van Melle, Beatrijs Bartelds, Floris-Jan S Ridderbos, Graziella Eshuis, Elisabeth B H J van Stratum, Salvador J Recinos, Brigitte W M Willemse, Hans Hillege, Tineke P Willems, Tjark Ebels, Rolf M F Berger
The unique, unphysiological Fontan circulation is associated with an impaired functional status of the patients that is suggested to deteriorate over time. Unfortunately, previous studies did not integrate both pulmonary and cardiac determinants of functional status. In addition, a comparison with the natural decrease in exercise capacity in healthy subjects (in both children and adults) is lacking. This single-center study aims to investigate the functional status in a cohort of Fontan patients in relation to time since Fontan completion and to identify its determinants, including cardiac characteristics and pulmonary characteristics...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#14
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622177/postoperative-respiratory-complications-in-patients-at-risk-for-obstructive-sleep-apnea-a-single-institution-cohort-study
#15
Satya Krishna Ramachandran, Jaideep Pandit, Scott Devine, Aleda Thompson, Amy Shanks
BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent condition that is associated with early postoperative respiratory complications (PRCs). As the majority of patients with OSA are undiagnosed, preoperative screening remains the most efficient method to identify suspected OSA. METHODS: This retrospective study was performed on patients undergoing anesthesia in a single academic medical center. We assigned OSA risk class retrospectively to all patients in the study by using the Perioperative Sleep Apnea Prediction (PSAP) score...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#16
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28615332/different-roles-for-inhibition-in-the-rhythm-generating-respiratory-network
#17
Kameron Decker Harris, Tatiana Dashevskiy, Joshua Mendoza, Alfredo J Garcia, Jan-Marino Ramirez, Eric Shea-Brown
Unraveling the interplay of excitation and inhibition within rhythm-generating networks remains a fundamental issue in neuroscience. We use a biophysical model to investigate the different roles of local and long-range inhibition in the respiratory network, a key component of which is the pre-Bötzinger complex inspiratory microcircuit. Increasing inhibition within the microcircuit results in a limited number of out-of-phase neurons before rhythmicity and synchrony degenerate. Thus, unstructured local inhibition is destabilizing and cannot support the generation of more than one rhythm...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28615037/high-sensitivity-and-negative-predictive-value-of-the%C3%A2-detect-algorithm-for-an-early-diagnosis-of-pulmonary-arterial-hypertension-in-systemic-sclerosis-application-in-a-single-center
#18
Alfredo Guillén-Del Castillo, Eduardo L Callejas-Moraga, Gabriela García, José F Rodríguez-Palomares, Antonio Román, Cristina Berastegui, Manuel López-Meseguer, Enric Domingo, Vicente Fonollosa-Plá, Carmen Pilar Simeón-Aznar
BACKGROUND: Pulmonary arterial hypertension (PAH) is one of the most relevant causes of death in systemic sclerosis. The aims of this study were to analyse the recently published DETECT algorithm comparing it with European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines: as screening of PAH; (2) identifying median pulmonary arterial pressure (mPAP) ≥21 mmHg; and (3) determining any group of pulmonary hypertension (PH). METHODS: Eighty-three patients fulfilling LeRoy's systemic sclerosis diagnostic criteria with at least right heart catheterization were studied retrospectively...
June 14, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28612697/what-is-the-applicability-of-a-novel-surveillance-concept-of-ventilator-associated-events
#19
Miia Jansson, Tero Ala-Kokko, Lauri Ahvenjärvi, Jaana Karhu, Pasi Ohtonen, Hannu Syrjälä
BACKGROUND In 2013, the Centers for Disease Control and Prevention released a novel surveillance concept called the "ventilator-associated event," which focused surveillance on objective measures of complications among patients that underwent invasive ventilations. OBJECTIVE To evaluate the concordance and possible differences in efficacy (ie, disease severity and outcomes) between 2 surveillance paradigms: (1) infection-related ventilator-associated complications (iVAC) and (2) on conventional ventilator-associated pneumonia (VAP)...
June 14, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28610897/efficacy-and-safety-of-etomidate-based-sedation-compared-with-propofol-based-sedation-during-ercp-in-low-risk-patients-a-double-blind-randomized-non-inferiority-trial
#20
Chan Hyuk Park, Se Woo Park, Bomi Hyun, Jin Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Min Ho Choi
BACKGROUND AND AIMS: Etomidate is a short-acting intravenous hypnotic with a safety profile that is superior to alternative drugs such as propofol. However, there is a lack of evidence on the safety of etomidate in endoscopic retrograde cholangiopancreatography (ERCP). The objective of this study was to compare efficacy and safety profiles of etomidate and propofol for endoscopic sedation. METHODS: This single-center, randomized, double-blind, non-inferiority trial included patients with American Society of Anesthesiologists (ASA) physical status I-II who had been scheduled for ERCP...
June 10, 2017: Gastrointestinal Endoscopy
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