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Sepsis guideline

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https://www.readbyqxmd.com/read/29678565/simplification-of-first-line-antibacterial-regimen-for-complicated-appendicitis-in-children-was-associated-with-better-adherence-to-guidelines-and-reduced-use-of-antibiotics
#1
Marion Taleb, Nicolas Nardi, Alexis Arnaud, Nathalie Costet, Pierre-Yves Donnio, Charlotte Engrand, Edouard Habonimana, Eric Wodey, Pierre Tattevin
Acute appendicitis in children requires early surgery, and a short course of antibiotics active on Enterobacteriaceae and anaerobes. Although aminoglycoside-containing 3-drug regimen have been used successfully for decades, simpler regimens with similar efficacy are increasingly used. We aimed to evaluate the impact of a switch from the combination of cefotaxime, metronidazole, and gentamicin (regimen 1), to piperacillin-tazobactam (regimen 2), as first-line regimen for complicated acute appendicitis in children...
April 17, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29678190/neonatal-and-congenital-malaria-a-case-series-in-malaria-endemic-eastern-uganda
#2
Peter Olupot-Olupot, Emma I E Eregu, Ketty Naizuli, Julie Ikiror, Linda Acom, Kathy Burgoine
BACKGROUND: Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed...
April 20, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#3
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29674562/newborn-early-onset-sepsis-guidelines-the-not-so-simple-truth
#4
Julie H Shakib
No abstract text is available yet for this article.
April 19, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29674201/placental-histopathological-lesions-in-correlation-with-neonatal-outcome-in-preeclampsia-with-and-without-severe-features
#5
Eran Weiner, Ohad Feldstein, Liliya Tamayev, Ehud Grinstein, Elad Barber, Jacob Bar, Letizia Schreiber, Michal Kovo
OBJECTIVE: We aimed to compare pregnancy outcome and placental histopathology in women with preeclampsia (PE) with and without severe features. METHODS: The medical records and placental pathology reports of all pregnancies complicated by PE during 2008-2016, were reviewed. Results were compared between those with and without severe features (severe PE vs. mild PE groups), according to current ACOG guidelines. Placental lesions were classified to maternal/fetal vascular supply lesions, and maternal/fetal inflammatory responses...
February 7, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#6
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#7
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29652926/assessment-of-costs-associated-with-adverse-events-in-patients-with-cancer
#8
William Wong, Yeun Mi Yim, Ashley Kim, Martin Cloutier, Marjolaine Gauthier-Loiselle, Patrick Gagnon-Sanschagrin, Annie Guerin
Adverse event (AE)-related costs represent an important component of economic models for cancer care. However, since previous studies mostly focused on specific AEs, treatments, or cancer types, limited information is currently available. Therefore, this study assessed the incremental healthcare costs associated with a large number of AEs among patients diagnosed with some of the most prevalent types of cancer. Data were obtained from a large US claims database. Adult patients were included if diagnosed with and treated for one of the following cancer types: breast, digestive organs and peritoneum, genitourinary organs (including bladder and ovary and other uterine adnexa), lung, lymphatic and hematopoietic tissue, and skin...
2018: PloS One
https://www.readbyqxmd.com/read/29652080/multicentre-observational-study-of-adherence-to-sepsis-six-guidelines-in-emergency-general-surgery
#9
(no author information available yet)
No abstract text is available yet for this article.
May 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29619807/-recommendations-for-the-care-of-patients-with-community-acquired-pneumonia-in-the-emergency-department
#10
A Julián-Jiménez, I Adán Valero, A Beteta López, L M Cano Martín, O Fernández Rodríguez, R Rubio Díaz, M A Sepúlveda Berrocal, J González Del Castillo, F J Candel González
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29603353/antimicrobial-stewardship-in-the-neonatal-unit-reduces-antibiotic-exposure
#11
K N McCarthy, A Hawke, E M Dempsey
AIM: Antimicrobial stewardship plays an important role in ensuring that the appropriate drug, dose, route and duration are employed to provide adequate treatment while minimizing the risks of unnecessary antibiotic use. Surveillance of antibiotic use with prescriber feedback is recommended as a high impact stewardship intervention. The aim of this study was to reduce unnecessary antimicrobial use in a neonatal unit. METHODS: A prospective audit was performed to assess compliance with antimicrobial guidelines...
March 30, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29599112/clinical-monitoring-of-well-appearing-infants-born-to-mothers-with-chorioamnionitis
#12
Neha S Joshi, Arun Gupta, Jessica M Allan, Ronald S Cohen, Janelle L Aby, Brittany Weldon, Juliann L Kim, William E Benitz, Adam Frymoyer
BACKGROUND: The risk of early-onset sepsis is low in well-appearing late-preterm and term infants even in the setting of chorioamnionitis. The empirical antibiotic strategies for chorioamnionitis-exposed infants that are recommended by national guidelines result in antibiotic exposure for numerous well-appearing, uninfected infants. We aimed to reduce unnecessary antibiotic use in chorioamnionitis-exposed infants through the implementation of a treatment approach that focused on clinical presentation to determine the need for antibiotics...
March 29, 2018: Pediatrics
https://www.readbyqxmd.com/read/29594891/removal-of-totally-implanted-venous-access-ports-for-suspected-infection-in-the-intensive-care-unit-a-multicenter-observational-study
#13
Marie Lecronier, Sandrine Valade, Naike Bigé, Nicolas de Prost, Damien Roux, David Lebeaux, Eric Maury, Elie Azoulay, Alexandre Demoule, Martin Dres
BACKGROUND: While no data support this practice, international guidelines recommend the removal of totally implanted venous access ports (TIVAPs) in patients with suspicion of TIVAP-related bloodstream infection admitted in the intensive care unit (ICU) for a life-threatening sepsis. METHODS: During this multicenter, retrospective and observational study, we included all patients admitted in five ICU for a life-threatening sepsis in whom a TIVAP was removed between January 2012 and December 2014...
March 27, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29577525/post-hematopoietic-stem-cell-transplant-hemophagocytic-lymphohistiocytosis-or-an-impostor-case-report-and-review-of-literature
#14
Anant Vatsayan, Irina Pateva, Linda Cabral, Jignesh Dalal, Rolla Abu-Arja
HLH occurring after HSCT is a relatively rare disease. Many conditions may mimic or trigger HLH in post-HSCT period (eg, cytokine release syndrome, engraftment syndrome, graft rejection/failure, acute graft-vs-host disease, infections systemic inflammatory response syndrome/sepsis, and thrombotic microangiopathy). Moreover, this period is usually marked by febrile illness, cytopenia, and a "cytokine storm" leading to elevation of inflammatory biomarkers like ferritin and sCD25. These parameters overlap with the diagnostic criteria for HLH...
March 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29577055/perianal-mucinous-adenocarcinoma-diagnosed-by-histological-study-of-anorectal-abscess-with-fistula
#15
Shir Li Jee, Hizami Amin-Tai, Nik Qisti Fathi, Mohd Faisal Jabar
Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29569847/review-article-sepsis-in-the-emergency-department-part-3-treatment
#16
REVIEW
Julian M Williams, Gerben Keijzers, Stephen Pj Macdonald, Amith Shetty, John F Fraser
Although comprehensive guidelines for treatment of sepsis exist, current research continues to refine and revise several aspects of management. Imperatives for rapid administration of broad-spectrum antibiotics for all patients with sepsis may not be supported by contemporary data. Many patients may be better served by a more judicious approach allowing consideration of investigation results and evidence-based guidelines. Conventional fluid therapy has been challenged with early evidence supporting balanced, restricted fluid and early vasopressor use...
April 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29564922/recognition-and-management-of-idiopathic-systemic-capillary-leak-syndrome-an-evidence-based-review
#17
Noor Ul-Ain Baloch, Marvi Bikak, Abdul Rehman, Omar Rahman
INTRODUCTION: Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases...
March 22, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29563673/transfusion-support-in-preterm-neonates-1500-g-and-or-32-weeks-in-a-tertiary-care-center-a-descriptive-study
#18
R A Shanmugha Priya, R Krishnamoorthy, Vinod Kumar Panicker, Binu Ninan
BACKGROUND: Lack of recent studies focusing on indications, pattern, and benefits of transfusions in low birth weight (B.Wt) and low gestational age (GA) preterm neonates prompted us to undertake this study. AIM: To estimate the transfusion requirements and outcomes in preterm neonates <1500 g and/or <32 weeks. SETTINGS AND DESIGN: This is a cross-sectional study conducted over a period of 2 years in a tertiary care center. MATERIALS AND METHODS: This study was conducted with 101 preterm neonates <1500 g and/or <32 weeks who received blood transfusions in the Neonatal Intensive Care Unit...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29558045/liver-dysfunction-in-sepsis
#19
REVIEW
Ewa A Woźnica, Małgorzata Inglot, Ryszard K Woźnica, Lidia Łysenko
Despite continuous progress in medicine, sepsis remains the main cause of deaths in the intensive care unit. Liver failure complicating sepsis/septic shock has a significant impact on mortality in this group of patients. The pathophysiology of sepsis-associated liver dysfunction is very complicated and still not well understood. According to the Surviving Sepsis Campaign (SSC) Guidelines, the diagnosis of liver dysfunction during sepsis is based on the increase in bilirubin concentration >2 mg/dL and the occurrence of coagulation disorders with INR > 1...
March 20, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29555789/targeting-skeletal-muscle-tissue-oxygenation-sto-2-in-adults-with-severe-sepsis-and-septic-shock-a-randomised-controlled-trial-oto-sts-study
#20
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
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