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David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
Christopher R Carpenter, Jay Banerjee, Daniel Keyes, Debra Eagles, Linda Schnitker, David Barbic, Susan Fowler, Michael A LaMantia
Cognitive dysfunction in older adults includes mild cognitive impairment, dementia, and delirium in addition to traumatic brain injury, intoxication, and central nervous system infections also encountered in younger populations. Delirium is an acute and reversible disturbance in attention with multiple potential precipitants, while mild cognitive impairment is an early form of Alzheimer's disease with memory and language problems only manifest with formal testing.1,2 On the other hand, dementia represents a chronic neurodegenerative disease that impairs executive functioning, memory, orientation, and judgment...
September 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Andreia B Alexander, Mary A Ott
As emergency physicians, we have all experienced the moment when we look at the patient board and the chief complaint "pregnancy test" pops up. The first thing we think to ourselves is, "Would have been cheaper to pick one up at the store." Upon chart review we see that this 19-year-old female, Jenny, has been in our ED 3 times in the past 2 years with the same request. Twice she was diagnosed with a sexually transmitted infection (STI), and this time her pregnancy test is positive. You personally saw her during one of the visits and referred her to OB/GYN (she was not able to make the visit)...
September 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Á D Rossi, F R Faucz, A Melo, P Pezzuto, G S de Azevedo, B L F Schamber-Reis, J S Tavares, J J Mattapallil, A Tanuri, R S Aguiar, C C Cardoso, C A Stratakis
BACKGROUND: Vertical transmission of Zika virus (ZIKV) is associated with congenital malformations but the mechanism of pathogenesis remains unclear. Although host genetics appear to play a role, no genetic association study has yet been performed to evaluate this question. In order to investigate if maternal genetic variation is associated with Congenital Zika Syndrome (CZS), we conducted a case-control study in a cohort of Brazilian women infected with ZIKV during pregnancy. METHODS: A total of 100 women who reported symptoms of zika during pregnancy were enrolled and tested for ZIKV...
September 17, 2018: Journal of Internal Medicine
Bin Zhu, Huanxin Meng, Baoxin Huang, ZhiBin Chen, Ruifang Lu
BACKGROUND: The study was designed to compare peri-implant microbial colonization of inflamed implants placed at different levels in dogs. METHODS: Two screwed-in (SI) and two tapped-in (TI) conical connection implants were placed on each side of mandibles in six dogs respectively. Four experimental groups were constituted according to implant types and placement depth in one side: SI crestally (SIC), SI 1.5 mm subcrestally (SIS), TI crestally (TIC), and TI 1.5 mm subcrestally (TIS)...
September 17, 2018: Journal of Periodontology
Julian Vitse, Huidi Tchero, Sylvie Meaume, Anne Dompmartin, Julie Malloizel-Delaunay, Chloé Géri, Christine Faure, Christian Herlin, Luc Teot
Flammacerium is a topical treatment composed of silver sulfadiazine and cerium nitrate initially used in burns. The objective was to assess the effectiveness of silver sulfadiazine and cerium nitrate on ischemic necrosis wounds of the lower limb as an alternative to amputation for a period of 12 weeks. Patients were prospectively randomized to receive silver sulfadiazine and cerium nitrate or standard care. Patients included adults with an ischemic wound of the lower limb, with necrosis covering over at least 50%...
September 2018: International Journal of Lower Extremity Wounds
Amira M Zakaria, Salwa F Ahmed, Mohamed S Motawae
Background Occupational hazards are the leading cause of morbidity and mortality among abattoirs personnel and animal workers. These hazards result from direct or indirect exposure to potential infection and several distressing events during routine procedures. Objectives To serologically investigate the potential occupational brucellosis hazard at Egyptian abattoirs. To provide an insight on the needed biosafety practices that should be implemented to mitigate the spread of occupational brucellosis among abattoir workers...
September 17, 2018: International Journal of Occupational and Environmental Health
Patricia A Pesavento, Cristina W Cunha, Hong Li, Kenneth Jackson, Donal O'Toole
A constraint on understanding the pathogenesis of malignant catarrhal fever (MCF) is the limited number of tools to localize infected cells. The amount of detectable virus, visualized in the past either by immunohistochemistry or in situ hybridization (ISH), has been modest in fixed or frozen tissues. This complicates our understanding of the widespread lymphoid proliferation, epithelial necrosis/apoptosis, and arteritis-phlebitis that characterize MCF. In this work, we developed a probe-based in situ hybridization assay targeting 2 ovine herpesvirus 2 (OvHV-2) genes, as well as their respective transcripts, in formalin-fixed tissues...
September 16, 2018: Veterinary Pathology
Kerriann M Casey, Amanda L Johnson, Melea N Hunrath, Jenelle K Fraser, Nicole C McCowan, Katherine Wasson, Rosalinda A Doty, Stephen M Griffey, Denise M Imai
Beginning in 2015, athymic nude sentinel mice from conventional, medium-, and high-security facilities presented to the Comparative Pathology Laboratory (CPL) with weight loss, diarrhea, and/or rectal prolapse. Regardless of whether clinical signs were present or absent, the gross observation of ceco-colonic thickening corresponded histologically to pleocellular typhlocolitis with mucosal hyperplasia and lamina proprial multinucleated cells. A subset of affected sentinels exhibited granulomatous serositis and hepatosplenic necrosis with multinucleated cells...
September 16, 2018: Veterinary Pathology
Terry R Spraker, Tetiana A Kuzmina, Eugene T Lyons, Robert L DeLong, Claire Simeone, D N Rao Veeramachaneni
A field study addressing causes of mortality in freshly dead northern elephant seals ( Mirounga angustirostris, Gill, 1866) was conducted on San Miguel Island, California, in February 2015. Necropsies were performed on 18 pups ranging in age from stillbirths to approximately 7 to 8 weeks. The primary gross diagnoses in these pups included trauma, myopathy, starvation/emaciation, infections, congenital anomalies, and perinatal mortality. However, 6 (33%) had a previously unrecognized myopathy characterized by multiple white streaks that were most obvious within the inner layer of the abdominal wall and the small innermost ventral intercostal muscles...
September 16, 2018: Veterinary Pathology
Lars Korn, Cornelia Betsch, Robert Böhm, Nicolas W Meier
OBJECTIVE: Most vaccines provide indirect community protection by preventing the transmission of the disease. Paradoxically, this effect can also motivate omission of vaccination because increasing vaccination rates reduce the risk of infection and, therefore, the individual benefit of vaccination. Consequently, vaccination becomes a social dilemma where individuals' interests conflict with group interests. The current study investigated two social nudge interventions aiming to increasing individuals' motivation to act in the group's interest...
September 17, 2018: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
E Reigadas, M Olmedo, M Valerio, S Vázquez-Cuesta, L Alcalá, M Marín, P Muñoz, E Bouza
OBJECTIVE: Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection (R-CDI). Despite its excellent efficacy, it is still not a routine procedure in most European centers. FMT has not been widely used in Spain to date. We describe our experience with FMT, including a novel approach based on oral fecal capsules. METHODS: We analyzed a prospectively recorded case series of patients with R-CDI treated with FMT at a single center (June 2014-July 2017)...
September 14, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Arwa Younis, Anat Wieder, Roy Beinart, Michael Glikson, Eyal Nof
BACKGROUND: Pacemaker pocket early post-implantation inflammation (EPII) is defined as clinical signs of local erythema without any systemic signs of infection occurring early after implantation. Data on the best treatment regimen for apparent superficial EPII is scarce. OBJECTIVES: To investigate the prognostic value of medical treatment, rather than extraction surgery, in patients with EPII. METHODS: Data from 6013 consecutive patients who underwent cardiac implantable electronic device (CIED) implantation or replacement from 2007-2015 were retrospectively analyzed; 40 (0...
September 2018: Israel Medical Association Journal: IMAJ
Jianguo Li, Mark Lovern, Michelle L Green, Joannellyn Chiu, Diansong Zhou, Craig Comisar, Yuan Xiong, Jeremy Hing, Merran MacPherson, James G Wright, Todd Riccobene, Timothy J Carrothers, Shampa Das
Ceftazidime-avibactam is a novel β-lactam/β-lactamase inhibitor combination for the treatment of serious infections caused by resistant Gram-negative pathogens. Population pharmacokinetic (PK) models were built to incorporate PK data from five Phase III trials in patients with complicated intra-abdominal infection, complicated urinary tract infection or nosocomial (including ventilator-associated) pneumonia. Ceftazidime and avibactam PK were well-described by two-compartment disposition models, with creatinine clearance (CrCL) the key covariate determining clearance variability...
September 17, 2018: Clinical and Translational Science
Gholamreza Pouladfar, Zahra Jafarpour, Seyed Ali Malek Hosseini, Mohammad Firoozifar, Razieh Rasekh, Leila Khosravifard
BACKGROUND: Bacterial infection in early period after liver transplant (LT) is the main cause of morbidity and mortality; however, data on children is limited. METHODS: To investigate the frequency, characteristics, and the associated factors of bacterial infection during hospitalization after LT, we prospectively enrolled all consecutive children with LT for a one-year, case-control study at the unique referral center of pediatric LT in Iran. RESULTS: Eighty-five events of bacterial infection were detected among 51 out of 94 LT recipients (54...
September 17, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Chinyere Onyearugbulem, Lauren Williams, Huirong Zhu, Maria C Gazzaneo, Ernestina Melicoff, Shailendra Das, Jorge Coss-Bu, Fong Lam, George Mallory, Flor M Munoz
Although infection is the leading cause of death in the first year following pediatric lung transplantation, there are limited data on risk factors for early infection. Sepsis remains under-recognized and under-reported in the early post-operative period for lung transplant recipients (LTR). We evaluated the incidence of infection and sepsis and identified risk factors for infection in the early post-operative period in pediatric LTRs. A retrospective review of medical records of LTRs at a large quaternary-care hospital from January 2009 to March 2016 was conducted...
September 17, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Shenglan Dai, Xiaohua Chen, Yongsheng Yu, Guoqing Zang, Zhenghao Tang
Hepatitis B virus (HBV) infection is a global public health problem. T helper (Th)1‑associated cytokines are involved in HBV clearance during acute and persistent infection. In our previous study, it was demonstrated that lentiviral vectors encoding ubiquitinated hepatitis B core antigen (LV‑Ub‑HBcAg) effectively transduced dendritic cells (DCs) to induce maturation, which promoted T cell polarization to Th1 and generated HBcAg‑specific cytotoxic T lymphocytes (CTLs) ex vivo. In the present study, HBV transgenic mice were immunized with LV‑Ub‑HBcAg‑transduced DCs and HBcAg‑specific immune responses were evaluated...
September 14, 2018: Molecular Medicine Reports
Kang Xiao, Qi Shi, Wei Zhou, Chen Gao, Cao Chen, Bao-Yun Zhang, Jing Wang, Xiao-Ping Dong
In order to definitively diagnosis sporadic Creutzfeldt‑Jakob disease (sCJD), brain tissue is currently required. Therefore, there is a great need for tests that can detect sCJD in body fluids or other types of tissues. Different variables, including the amount of recombinant celluar prion protein (rPrPC), salt, cleaning surfactants and thioflavin T (ThT), in human cerebrospinal fluid (CSF) were evaluated. The reagent concentrations of 1X PBS, 170 mM NaCl, 1 mM EDTA, 0.01 mM ThT and 0.001% SDS, and the amounts of 10 µg rPrPC and 10 µl CSF were considered to be optimal for the real‑time quaking‑induced conversion (RT‑QuIC) assay...
September 7, 2018: International Journal of Molecular Medicine
James G Coey, Paula J Whittaker, Greg Williams, Umar H Ikram, Oliver J R Page
BACKGROUND: It has been proposed that fibrin tissue adhesive (FTA) can act as an effective alternative to nasal packing in managing the postoperative symptoms of endoscopic nasal surgery. METHODOLOGY: MEDLINE, Embase, Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature and were searched for randomised controlled trials comparing FTA with nasal packing in endoscopic nasal surgery. The primary outcome of interest was bleeding; secondary outcomes included pain, nasal obstruction, infection, adhesions and the formation of granulation tissue...
September 17, 2018: Rhinology
A J van Winkelhoff, F Abbas, T J H Siebers
Dental focal infections are extraoral manifestations caused by oral pathogens. Pathological oral conditions, such as periapical inflammation and periodontitis, can cause bacteremia. Dissemination of oral pathogens to nonoral sites can subsequently cause infections in extraoral tissues and organs. Cardiovascular infections and brain abscesses are the most common of these. The course of such infections can be lethal. In order to improve patient care, a closer collaboration between dental and medical caregivers is necessary...
September 2018: Nederlands Tijdschrift Voor Tandheelkunde
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