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Antibiotics AND end of life

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https://www.readbyqxmd.com/read/29785130/human-herpesvirus-6-pneumonitis-in-a-patient-with-follicular-lymphoma-following-immunochemotherapy-with-rituximab
#1
Saeko Kuwahara-Ota, Yoshiaki Chinen, Yoshimi Mizuno, Tomoko Takimoto-Shimomura, Yayoi Matsumura-Kimoto, Kazuna Tanba, Taku Tsukamoto, Shinsuke Mizutani, Yuji Shimura, Tsutomu Kobayashi, Shigeo Horiike, Junya Kuroda
Primary infection with human herpesvirus-6 (HHV-6) commonly occurs at an early age in children, most often at 3 years of age, and is associated with childhood diseases, such as exanthema subitum, hepatitis, febrile convulsions, or encephalitis. However, the virus occasionally reactivates from its latent state in immunosuppressed adults, especially post-transplant, resulting in serious disseminated, sometimes life-threatening end-organ complications. Herein, we report a case of a 68-year-old man with relapsed follicular lymphoma who developed HHV-6 pneumonitis...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#2
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29724399/treatment-compliance-in-cystic-fibrosis-patients-with-chronic-pseudomonas-aeruginosa-infection-treated-with-tobramycin-inhalation-powder-the-free-study
#3
Francesco Blasi, Vincenzo Carnovale, Giuseppe Cimino, Vincenzina Lucidi, Donatello Salvatore, Barbara Messore, Marta Bartezaghi, Elisa Muscianisi, Pasquale Alberto Porpiglia
BACKGROUND: A high treatment burden with nebulised therapies in cystic fibrosis (CF) patients is the major limitation for treatment compliance; moreover, studies on treatment compliance with inhaled antibiotics are limited. This study assessed compliance to TOBI® Podhaler™ (TIP) treatment in CF patients with chronic Pseudomonas aeruginosa (Pa) infections in a real-world setting using the Italian Treatment Adherence CF Questionnaire (ITA-CFq). METHODS: This longitudinal, multicentre, cohort study included 2 follow-up (FU) visits: FU-1 at 3-months±15-days from the baseline visit and FU-2 at the end of third TIP cycle (or 6-months after enrolment, whichever occurred first)...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29722725/antegrade-enema-after-total-mesorectal-excision-for-rectal-cancer-the-last-chance-to-avoid-definitive-colostomy-for-refractory-low-anterior-resection-syndrome-and-fecal-incontinence
#4
Romain Didailler, Quentin Denost, Paula Loughlin, Edouard Chabrun, Julie Ricard, Flor Picard, Frank Zerbib, Eric Rullier
BACKGROUND: Total mesorectal excision and preoperative radiotherapy in mid and low rectal cancer allow us to achieve very good oncological results. However, major and refractory low anterior resection syndrome and fecal incontinence alter the quality of life of patients with a long expected life span. OBJECTIVE: We assessed the functional results of patients treated by antegrade enema for refractory low anterior resection syndrome and fecal incontinence after total mesorectal excision...
June 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29722636/recent-advances-in-nanomedicine-for-sepsis-treatment
#5
Simseok A Yuk, Diego A Sanchez-Rodriguez, Michael D Tsifansky, Yoon Yeo
Sepsis and septic shock are life-threating conditions, which form a continuum of the body's response to overwhelming infection. The current treatment consists of fluid and metabolic resuscitation, hemodynamic and end-organ support, and timely initiation of antibiotics. However, these measures may be ineffective and the sepsis-related mortality toll remains substantial; therefore, an urgent need exists for new therapies. Recently, several nanoparticle (NP) systems have shown excellent protective effects against sepsis in preclinical models, suggesting a potential utility in the management of sepsis and septic shock...
May 1, 2018: Therapeutic Delivery
https://www.readbyqxmd.com/read/29712731/characterization-of-chlamydial-rho-and-the-role-of-rho-mediated-transcriptional-polarity-during-interferon-gamma-mediated-tryptophan-limitation
#6
Scot P Ouellette, Parker R Messerli, Nicholas A Wood, Heather Hajovsky
As an obligate intracellular, developmentally regulated bacterium, Chlamydia is sensitive to amino acid fluctuations within its host cell. When human epithelial cells are treated with the cytokine interferon-γ (IFNγ), the tryptophan (trp)-degrading enzyme, indoleamine-2,3-dioxygenase, is induced. Chlamydiae within such cells are starved for trp and enter a state of so-called persistence. Chlamydia lacks the stringent response used by many eubacteria to respond to this stress. Unusually, chlamydial transcription is globally elevated during trp starvation with transcripts for trp-codon containing genes disproportionately increased...
April 30, 2018: Infection and Immunity
https://www.readbyqxmd.com/read/29710673/biotic-and-abiotic-dissipation-of-tetracyclines-using-simulated-sunlight-and-in-the-dark
#7
M Conde-Cid, D Fernández-Calviño, J C Nóvoa-Muñoz, M Arias-Estévez, M Díaz-Raviña, M J Fernández-Sanjurjo, A Núñez-Delgado, E Álvarez-Rodríguez
Veterinary antibiotics reaching soils and water bodies are considered emerging pollutants deserving special attention. In this work, dissipation of tetracycline (TC), oxytetracycline (OTC) and chlortetracycline (CTC) is investigated. Dissipation experiments in filtered water, using simulated sunlight, resulted in the following degradation sequence: TC < OTC ≈ CTC, with half-life values of 229, 101 and 104 min, respectively; however, no dissipation took place in the dark. Dissipation of the three tetracyclines in culture medium and with simulated sunlight was much higher, giving the sequence TC ≈ OTC < CTC, with half-lives of 9, 10 and 7 min, respectively; in the dark, TC and OTC did not suffer dissipation, but it was around 28% for CTC at the end of the experiment (480 min)...
April 25, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29660401/intravenous-fosfomycin-for-pulmonary-exacerbation-of-cystic-fibrosis-real-life-experience-of-a-large-adult-cf-centre
#8
G Spoletini, M Kennedy, L Flint, T Graham, C Etherington, N Shaw, P Whitaker, M Denton, I Clifton, D Peckham
BACKGROUND: The increased prevalence of multi-drug resistant strains of P.aeruginosa and allergic reactions among adult patients with cystic fibrosis (CF) limits the number of antibiotics available to treat pulmonary exacerbations. Fosfomycin, a unique broad spectrum bactericidal antibiotic, might offer an alternative therapeutic option in such cases. AIM: To describe the clinical efficacy, safety and tolerability of intravenous fosfomycin in combination with a second anti-pseudomonal antibiotic to treat pulmonary exacerbations in adult patients with CF...
April 13, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29629982/end-of-life-care-in-icus-in-east-asia-a-comparison-among-china-korea-and-japan
#9
So Young Park, Jason Phua, Masaji Nishimura, Yiyun Deng, Yan Kang, Keiichi Tada, Younsuck Koh
OBJECTIVES: To compare physicians' perceptions and practice of end-of-life care in the ICU in three East Asian countries cultures similarly rooted in Confucianism. DESIGN: A structured and scenario-based survey of physicians who managed ICU patients from May 2012 to December 2012. SETTING: ICUs in China, Korea, and Japan. SUBJECTS: Specialists who are either intensivists or nonintensivist primary attending physicians in charge of patients (195 in China, 186 in Korea, 224 in Japan)...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29623632/out-of-pocket-expenditures-indirect-costs-and-health-related-quality-of-life-of-patients-with-pulmonary-tuberculosis-in-thailand
#10
Pimwara Tanvejsilp, Mark Loeb, Jonathan Dushoff, Feng Xie
BACKGROUND: Thailand's hospitals may adopt different supervision approaches to improve tuberculosis (TB) treatment adherence. OBJECTIVE: The aim of this study was to compare out-of-pocket (OOP) expenditures, indirect costs, and health-related quality of life (HRQoL) among TB patients who received pharmaceutical care (pharmacist-led patient education and telephone consultation), home visit, and self-administered therapy (SAT) in Thailand. METHODS: We conducted a prospective study to collect OOP expenditures, indirect costs, and HRQoL from a subsample of 104 adult pulmonary TB patients who started treatment between January and May 2014 in three hospitals...
September 13, 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29564147/prehospital-recognition-and-antibiotics-for-999-patients-with-sepsis-protocol-for-a-feasibility-study
#11
Chris Moore, Jenna Bulger, Matt Morgan, Timothy Driscoll, Alison Porter, Saiful Islam, Mike Smyth, Gavin Perkins, Bernadette Sewell, Timothy Rainer, Prabath Nanayakkara, Chukwudi Okolie, Susan Allen, Greg Fegan, Jan Davies, Theresa Foster, Nick Francis, Fang Gao Smith, Gemma Ellis, Tracy Shanahan, Robin Howe, Helen Snooks
Background: Sepsis is a common condition which kills between 36,000 and 64,000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce mortality and improve the health and well-being of people with sepsis. Paramedics frequently come into contact with patients with sepsis and are well placed to provide early diagnosis and treatment.We aim to determine the feasibility of undertaking a fully powered randomised controlled trial (RCT) to test the clinical and cost-effectiveness of paramedics obtaining blood cultures from and administering IV antibiotics to patients with sepsis, so we can make a decision about whether to proceed to a fully powered randomised controlled trial, which will answer questions regarding safety and effectiveness for patients and benefit to the National Health Service (NHS)...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29524025/root-end-surgery-with-leucocyte-and-platelet-rich-fibrin-and-an-occlusive-membrane-a-randomized-controlled-clinical-trial-on-patients-quality-of-life
#12
Nastaran Meschi, Steffen Fieuws, Anke Vanhoenacker, Olaf Strijbos, Dominique Van der Veken, Constantinus Politis, Paul Lambrechts
OBJECTIVES: The aim of this study was to investigate the impact of the adjunct of leukocyte- and platelet-rich fibrin (LPRF) to root-end surgery (RES) on the patients' quality of life during the first week post RES. MATERIALS AND METHODS: Patients in need of RES were recruited for an open randomized controlled clinical trial (RCT) with a 2 × 2 factorial design. They were randomly allocated to the test (+LPRF) and control (-LPRF) group. Each group was subsequently divided into two strata: with or without an occlusive membrane (Bio-Gide®, Geistlich Biomaterials, Switzerland; BG)...
March 9, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29468162/short-term-oral-antibiotics-treatment-promotes-inflammatory-activation-of-colonic-invariant-natural-killer-t-and-conventional-cd4-t-cells
#13
Claudia Burrello, Federica Garavaglia, Fulvia Milena Cribiù, Giulia Ercoli, Silvano Bosari, Flavio Caprioli, Federica Facciotti
The gut mucosa is continuously exposed to a vast community of microorganisms, collectively defined as microbiota, establishing a mutualistic relationship with the host and contributing to shape the immune system. Gut microbiota is acquired at birth, and its composition is relatively stable during the entire adult life. Intestinal dysbiosis, defined as a microbial imbalance of gut bacterial communities, can be caused by several factors, including bacterial infections and antibiotic use, and has been associated with an increased risk to develop or exacerbate immune-mediated pathologies, such as allergic reactions, asthma, and inflammatory bowel diseases...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29454083/incidence-of-acute-suppurative-sialadenitis-in-end-stage-cancer-patients-a-retrospective-observational-study
#14
Hiroaki Watanabe, Takuya Odagiri, Yasuyuki Asai
CONTEXT: Acute suppurative sialadenitis (hereafter referred to as sialadenitis) is accompanied by pain and fever and can diminish the quality of life in end-stage cancer patients; however, its incidence is not clear. OBJECTIVES: We conducted this study to elucidate the incidence of sialadenitis in end-stage cancer patients. METHODS: Retrospective review and observational study based on patients' medical records. SUBJECTS: About 726 consecutive cancer patients who died on the palliative care unit of our hospital between April 2012 and November 2016 were included...
February 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29440148/interventions-in-hospitalised-patients-with-cancer-the-importance-of-impending-death-awareness
#15
Eric Cornelis Theodorus Geijteman, Marcella van der Graaf, Frederika E Witkamp, Sanne van Norden, Bruno H Stricker, Carin C D van der Rijt, Agnes van der Heide, Lia van Zuylen
OBJECTIVES: Burdensome and futile interventions with the aim of prolonging life should be avoided in dying patients. However, current clinical practice has hardly been investigated.We examined the number and type of diagnostic and therapeutic medical interventions in hospitalised patients with cancer in their last days of life. In addition, we investigated if physician awareness of impending death affected the use of these interventions. METHODS: Questionnaire study and medical record study...
February 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29415232/maternal-antibiotic-exposure-during-pregnancy-and-hospitalization-with-infection-in-offspring-a-population-based-cohort-study
#16
Jessica Eden Miller, Chunsen Wu, Lars Henning Pedersen, Nicholas de Klerk, Jørn Olsen, David P Burgner
Background: The early life microbiome contributes to immune development. Antibiotics during pregnancy alter the microbiome and may influence disease risks in the offspring. We investigated the relationship between maternal antibiotic exposure before and during pregnancy, and risk of childhood hospitalization with infection. Methods: We used population-based Danish national databases for pregnancies between 1995 and 2009. Infants were followed from birth until their first infection-related hospitalization, death, 14th birthday, emigration or end-2009...
April 1, 2018: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29368789/techniques-for-repair-of-obstetric-anal-sphincter-injuries
#17
Melanie R Meister, Joshua I Rosenbloom, Jerry L Lowder, Alison G Cahill
Importance: Obstetric anal sphincter injuries (OASISs) complicate up to 11% of vaginal deliveries; obstetricians must be able to recognize and manage these technically challenging injuries. Objective: The aim of this study was to share our approach for management of these challenging complications of childbirth based on a multidisciplinary collaboration between general obstetrician-gynecologists, maternal fetal medicine specialists, and female pelvic medicine and reconstructive surgeons established at our institution...
January 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#18
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29247229/salford-lung-study-in-chronic-obstructive-pulmonary-disease-sls-copd-follow-up-interviews-on-patient-centred-outcomes
#19
Lynda Doward, Henrik Svedsater, Diane Whalley, Rebecca Crawford, David Leather, James Lay-Flurrie, Nick Bosanquet
This study investigated patient perceptions, experiences and management of COPD throughout the SLS COPD study. Follow-up interviews were conducted with 400 patients who completed SLS COPD; a mixed-methods approach was used to collect quantitative and qualitative information. Structured interviews using closed-ended questions were conducted with 360 patients, detailing aspects of background/lifestyle information and COPD. Extended interviews containing open-ended questions on perceptions of COPD and quality of life (QoL) in addition to the closed-ended questions were completed by 40 further patients...
December 15, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29238752/colonic-butyrate-producing-communities-in-humans-an-overview-using-omics-data
#20
Marius Vital, André Karch, Dietmar H Pieper
Given the key role of butyrate for host health, understanding the ecology of intestinal butyrate-producing communities is a top priority for gut microbiota research. To this end, we performed a pooled analysis on 2,387 metagenomic/transcriptomic samples from 15 publicly available data sets that originated from three continents and encompassed eight diseases as well as specific interventions. For analyses, a gene catalogue was constructed from gene-targeted assemblies of all genes from butyrate synthesis pathways of all samples and from an updated reference database derived from genome screenings...
November 2017: MSystems
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