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https://www.readbyqxmd.com/read/28214181/-adult-immunisation-general-points-hot-topics-and-perspectives
#1
P Loubet, O Launay
Vaccination in immunocompetent adult mainly concerns booster vaccination against diphtheria, tetanus, polio and pertussis. Some chronic diseases may also require the achievement of pneumococcal and influenza vaccines. In addition, from the age of 65, annual influenza vaccination as well as one dose of a live attenuated shingles vaccine between 64 and 75 years are recommended. Immunocompromised adults, due to the increased risk of serious infections responsible of significant morbidity and mortality, are particularly concerned by vaccination...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#2
Lindsay Caspari, Elizabeth Epstein, Amy Blackman, Li Jin, David A Kaufman
BACKGROUND: The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. METHODS: An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button...
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28214101/endophthalmitis-reduction-with-intracameral-moxifloxacin-prophylaxis-analysis-of-600%C3%A2-000-surgeries
#3
Aravind Haripriya, David F Chang, Ravilla D Ravindran
PURPOSE: To compare the postoperative endophthalmitis rate before and after initiation of intracameral (IC) moxifloxacin prophylaxis for both phacoemulsification and sutureless, manual small-incision cataract surgery (M-SICS), as well as in patients with posterior capsular rupture (PCR). DESIGN: Retrospective, clinical registry. PARTICIPANTS: All cataract surgeries (617 453) performed during the 29-month period from January 2014 to May 2016 at the 10 regional Aravind eye hospitals were included...
February 14, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28214083/the-effect-of-nonpharmacological-training-on-delirium-identification-and-intervention-strategies-of-intensive-care-nurses
#4
Ayşegül Öztürk Birge, Hatice Tel Aydin
OBJECTIVE: This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. METHOD: This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms...
February 14, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28214069/-pharmacokinetic-drug-interaction-between-miconazole-mucoadhesive-tablet-and-tacrolimus-about-3%C3%A2-case-reports-in-transplant-patients
#5
Marion Lepelley, Sophie Logerot, Xavier Fonrose, Céline Villier
Loramyc(®) is a mucoadhesive tablet of miconazole, indicated for the treatment of oropharyngeal candidiasis in immunocompromised patients. Miconazole, as others azole antifungals, is known for its potent inhibitory properties of cytochromes P450 enzymes and P-glycoprotein (P-gp). Inhibition of cytochromes P450 enzymes and P-gp can produce pharmacokinetic drug interaction. Immunosuppressive agents, such as calcineurin inhibitors (tacrolimus, cyclosporine) are substrates of cytochromes P450 3A4 and P-gp. Nevertheless, the impact of systemic absorption of miconazole mucoadhesive tablet has not been investigated by the laboratory before regulatory approval...
January 12, 2017: Thérapie
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#6
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213808/genotyping-and-antifungal-susceptibility-of-dipodascus-capitatus-isolated-in-a-neonatal-intensive-care-unit-of-a-sicilian-hospital
#7
Teresa Fasciana, Mario Giuffrè, Cinzia Calà, Ingrid Anne Mandy Schierz, Giuseppe Aquilina, Giuseppa Pinello, Giuseppina Capra, Dario Lipari, Giovanni Corsello, Anna Giammanco
In August 2015, Dipodascus capitatus was isolated from two patients admitted to the neonatal intensive care unit. Nosocomial acquisition of the fungus was suspected and epidemiological studies were undertaken. The patients were simultaneously hospitalized, and the comparison of the two isolates by two independent molecular typing methods have confirmed clonal dissemination of a single strain of D. capitatus. Antimicrobial susceptibility testing was useful for identifying the appropriated antifungal therapy in micafungin...
February 18, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28213800/invasive-aspergillus-laryngotracheobronchitis-in-an-adult-with-primary-cns-lymphoma
#8
Mark E Barry, William Walsh Thomas, Buer Song, Natasha Mirza
Invasive aspergillosis can be difficult to diagnose, and early recognition and initiation of therapy is imperative for improving patient outcomes. A case of invasive Aspergillus laryngotracheobronchitis is presented here with a review of the relevant literature. A 58-year-old male undergoing treatment for CNS lymphoma presented with neutropenic sepsis and acute respiratory distress requiring intubation. Following extubation, he reported persistent hoarseness for 1-month duration and he was found to have pseudomembranous plaques and ulcers of the larynx, trachea, and right mainstem bronchus consistent with Aspergillus laryngotracheobronchitis...
February 17, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28213620/post-contrast-acute-kidney-injury-in-intensive-care-unit-patients-a-propensity-score-adjusted-study
#9
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes, Kianoush Kashani
PURPOSE: To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examination. METHODS: All ICU patients at our institution who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) CT scan from January 2006 to December 2014 were identified...
February 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28213403/temporal-dissociation-between-minimal-distal-to-aortic-pressure-ratio-and-peak-hyperemia-during-intravenous-adenosine-infusion
#10
Lorena Casadonte, Koen M Marques, Jos Ae Spaan, Maria Siebes
The present study sought to compare the temporal relation between maximal coronary flow (peak hyperemia) and minimal coronary/aortic (Pd/Pa) pressure ratio for intracoronary (IC) and intravenous (IV) adenosine administration. Peak hyperemia is assumed to coincide with the minimal Pd/Pa value. However, this has not been confirmed for systemic hemodynamic variations during IV adenosine infusion. Hemodynamic responses to IV and IC adenosine administration were obtained in 12 patients (14 lesions) using combined intracoronary pressure and flow velocity measurements...
February 17, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#11
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28213375/a-deep-ethics-for-mental-difference-and-disability-the-case-of-vincent-van-gogh
#12
Bradley Lewis
Despite a growing prevalence of mental illness diagnoses and treatments, there remains remarkable interpretive diversity regarding the meaning of these diagnoses and their implication for mental healthcare. Humanities scholarship devoted to language, power and ethical cares of the self provides invaluable tools for navigating interpretive diversity in this domain. This scholarship suggests that ethical questions of informed consent regarding mental difference and disability go much deeper than the usual standards...
February 17, 2017: Medical Humanities
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#13
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28212906/utility-of-failure-mode-and-effect-analysis-to-improve-safety-in-suctioning-by-orotracheal-tube
#14
Agustín Vázquez-Valencia, Andrés Santiago-Sáez, Bernardo Perea-Pérez, Elena Labajo-González, Maria Elena Albarrán-Juan
OBJECTIVE: The objective of the study was to use the Failure Mode and Effect Analysis (FMEA) tool to analyze the technique of secretion suctioning on patients with an endotracheal tube who were admitted into an intensive care unit. MATERIALS AND METHODS: Brainstorming was carried out within the service to determine the potential errors most frequent in the process. After this, the FMEA was applied, including its stages, prioritizing risk in accordance with the risk prioritization number (RPN), selecting improvement actions in which they have an RPN of more than 300...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28212900/basic-educational-needs-of-midwifery-students-for-taking-the-role-of-an-assistance-in-disaster-situations-a-cross-sectional-study-in-iran
#15
Z Taghizadeh, M Khoshnam Rad, A Montazeri
BACKGROUND: After disasters, the disaster medical assistance team composed of skilful healthcare staff should be available at the disaster site for providing care to disaster's victims. It is believed that midwives are at the front line of the disaster management team and should be prepared for providing care to mothers and children. OBJECTIVES: To investigate the midwifery students' basic educational needs for taking the role of an assistant in disaster situations...
January 22, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28212589/a-multicenter-initiative-for-critical-congenital-heart-disease-newborn-screening-in-texas-neonatal-intensive-care-units
#16
Alice Gong, Charleta Guillory, Liza Creel, Judith Ellen Livingtson, Tiffany M McKee-Garrett, Regine Fortunov
Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28212588/colorectal-polypectomy-and-endoscopic-mucosal-resection-emr-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#17
Monika Ferlitsch, Alan Moss, Cesare Hassan, Pradeep Bhandari, Jean-Marc Dumonceau, Gregorios Paspatis, Rodrigo Jover, Cord Langner, Maxime Bronzwaer, Kumanan Nalankilli, Paul Fockens, Rawi Hazzan, Ian M Gralnek, Michael Gschwantler, Elisabeth Waldmann, Philip Jeschek, Daniela Penz, Denis Heresbach, Leon Moons, Arnaud Lemmers, Konstantina Paraskeva, Juergen Pohl, Thierry Ponchon, Jaroslaw Regula, Alessandro Repici, Matthew D Rutter, Nicholas G Burgess, Michael J Bourke
1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation...
February 17, 2017: Endoscopy
https://www.readbyqxmd.com/read/28212478/-risk-factors-related-with-ventilator-associated-pneumonia-in-a-neonatal-intensive-care-therapy
#18
Juan Pablo Romo-Gamboa, Bertha Alicia Sandoval-Pérez, Ana Bertha Rodríguez-López, Marco Antonio Torres-González, Juan Carlos Barrera-de León
BACKGROUND: Ventilator-associated pneumonia (VAP) represents the second cause of nosocomial infections and it is associated with greater morbility, duration of mechanical ventilation (MV), and hospital stay. The objective was to determine factors related with VAP in neonates. METHODS: Analytical transversal study including newborns admitted already intubated with at least 48 hours of MV or who were intubated in Neonatal Therapy. VAP was defined according to the criteria of the Centers for Disease Control and Prevention: "those patients submitted to MV during at least 48 hours"...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28212098/a-2-5-mw-ch-50-mcps-10-analog-channel-adaptively-biased-read-out-front-end-ic-with-low-intrinsic-timing-resolution-for-single-photon-time-of-flight-pet-applications-with-time-dependent-noise-analysis-in-90-nm-cmos
#19
Hugo Cruz, Hong-Yi Huang, Ching-Hsing Luo, Shuenn-Yuh Lee
This paper presents a 10-channel time-of-flight application-specific integrated circuit (ASIC) for positron emission tomography in a 90 nm standard CMOS process. To overcome variations in channel-to-channel timing resolution caused by mismatch and process variations, adaptive biases and a digital-to-analog converter (DAC) are utilized. The main contributions of this work are as follows. First, multistage architectures reduce the total power consumption, and detection bandwidths of analog preamplifiers and comparators are increased to 1 and 1...
February 13, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28212059/pediatric-chest-ct-diagnostic-reference-ranges-development-and-application
#20
Keith J Strauss, Marilyn J Goske, Alexander J Towbin, Debapriya Sengupta, Michael J Callahan, Kassa Darge, Daniel J Podberesky, Donald P Frush, Charles Maxfield, Sjirk J Westra, Jeffrey S Prince, Huimin Wu, Mythreyi Bhargavan-Chatfield
Purpose To determine diagnostic reference ranges on the basis of the size of a pediatric patient's chest and to develop a method to estimate computed tomographic (CT) scanner-specific mean size-specific dose estimates (SSDEs) as a function of patient size and the radiation output of each CT scanner at a site. Materials and Methods The institutional review boards of each center approved this retrospective, HIPAA-compliant, multicenter study; informed consent was waived. CT dose indexes (SSDE, volume CT dose index, and dose length product) of 518 pediatric patients (mean age, 9...
February 17, 2017: Radiology
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