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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
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
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#2
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28320186/neurological-complications-after-tuberculous-meningitis-in-a-multi-state-cohort-in-the-united-states
#3
Alexander E Merkler, Alexandra S Reynolds, Gino Gialdini, Nicholas A Morris, Santosh B Murthy, Kiran Thakur, Hooman Kamel
BACKGROUND AND PURPOSE: To assess the rate of neurological complications and mortality after tuberculous meningitis in the United States. METHODS: The authors performed a retrospective cohort study of all patients 18years or older hospitalized for tuberculous meningitis in California between 2005 and 2010, New York between 2006 and 2012, and Florida between 2005 and 2012. Outcomes of interest were mortality and the following neurological complications: stroke, seizure, hydrocephalus requiring a ventriculoperitoneal shunt, vision impairment, and hearing impairment...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320174/etiological-agents-of-viral-meningitis-in-children-from-a-dengue-endemic-area-southeast-region-of-brazil
#4
Danilo B de Oliveira, Talitah M Candiani, Ana Paula M Franco-Luiz, Gabriel M F Almeida, Jônatas S Abrahão, Maria Rios, Roney S Coimbra, Erna G Kroon
Meningitis is a disease with a global distribution that constitutes a worldwide burden, with viruses as the primary etiologic agents. The range of viral meningitis severity depends mainly on age, immune status and etiological agent. The aim of this work was to investigate the suspected cases of viral meningitis using molecular techniques to confirm the viral infection. The diagnosed virus was correlated with clinical findings and cytochemical parameters in cerebrospinal liquid (CSF) of patients. CSF of 70 children with the presumptive diagnosis of viral meningitis was analyzed by real time PCR (qPCR)...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320169/probable-zika-virus-associated-guillain-barr%C3%A3-syndrome-challenges-with-clinico-laboratory-diagnosis
#5
Eliza Miller, Zoe Becker, Daniel Shalev, Christopher T Lee, Comana Cioroiu, Kiran Thakur
A 55year old woman in New York City presented in May 2016 with progressive weakness, ataxia, paresthesia, and areflexia, shortly after returning from the Dominican Republic. Lumbar puncture revealed cytoalbuminological dissociation. Due to her recent travel, Zika-associated Guillain Barré syndrome (GBS) was suspected and she underwent evaluation for recent flavivirus exposure. Zika virus RNA was not detected in serum, but Zika virus immunoglobulin M (IgM) was detected in both serum and cerebrospinal fluid...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320159/prevalence-of-peripheral-neuropathy-and-associated-factors-in-hiv-infected-patients
#6
Maria Luiza Areal Corrêa de Sá E Benevides, Sérgio Beduschi Filho, Rodrigo Debona, Eduardo Novaes Costa Bergamaschi, Jean Costa Nunes
The progress on HIV infection treatment has allowed a longer survival for HIV-infected patients. However, chronic comorbidities are emerging. Peripheral Neuropathy (PN) represents one of the most prevalent neurologic disorders among these patients, and comprehensive studies may contribute to a reduction in the morbidity of this condition. This is a cross-sectional analytic study conducted in a tertiary referral hospital in southern Brazil. This study investigates the prevalence of PN among HIV-infected patients and associated demographic, clinical and laboratory variables...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320142/ventriculo-peritoneal-shunt-surgery-for-tuberculous-meningitis-a-systematic-review
#7
Imran Rizvi, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Eesha Sharma, Chhitij Srivastava, Ravi Uniyal
BACKGROUND: Ventriculo-peritoneal shunt surgery is one of the most commonly performed surgery for the management of tuberculous hydrocephalus. There is decreased clarity on issues regarding the indication as well as timing of cerebrospinal fluid diversion procedures in tuberculous meningitis. We systematically analysed published literature on this subject with an objective to assess the value of cerebrospinal fluid diversion procedures in tuberculous meningitis. METHODS: A systematic search of literature was performed using PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) for articles published till August 2016...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320052/soft-tissue-infections-from-fish-spike-wounds-normal-commensal-bacteria-are-more-common-than-marine-pathogens
#8
Hannah Collins, Kin Mun Lee, Paul T-Y Cheng, Sarah Hulme
BACKGROUND: A fish spike injury can be sustained by anyone handling fish; during fishing, meal preparation or in retail. Case reports of fish spikes inoculating victims with virulent marine-specific pathogens and causing systemic illness led us to question whether empirical treatment of these injuries with amoxicillin and clavulanic acid is adequate. METHODS: This 2-year prospective observational study was conducted at Middlemore Hospital, Auckland, New Zealand...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28320041/prevention-of-iron-overload-and-long-term-maintenance-of-normal-iron-stores-in-thalassaemia-major-patients-using-deferiprone-or-deferiprone-deferoxamine-combination
#9
Annita Kolnagou, Christina N Kontoghiorghe, George J Kontoghiorghes
Decrease in mortality and morbidity is observed in thalassaemia major patients with reduced iron load in comparison to heavy iron loaded patients. Effective and complete treatment of transfusional iron overload can be achieved by chelation protocols that can eliminate excess iron and maintain normal iron stores (NIS). The maintenance of NIS, i. e., serum ferritin (350 μg/L >), MRI T2* cardiac (>20 ms) and liver (>6.3 ms) relaxation time levels was monitored in 16 thalassaemia major patients (32-53 years, 12 splenectomized, 10 male, erythrocyte transfusions 120-323 ml/kg/year) for about 90 patient years...
March 20, 2017: Drug Research
https://www.readbyqxmd.com/read/28320030/changes-in-regulatory-t-cell-levels-in-acute-cerebral-ischemia
#10
Xuerui Pang, Weidong Qian
Background Acute stroke causes intense and significant changes in the immune system as well as in the number and the ratio of various immune cells. Material and Methods Several large-scale studies have shown that ischemic stroke leaves the human body in a state of immunodepression. The regulatory T (Treg) cells may be strongly associated with a change of immune status. In this trial, we collected venous blood from a cohort of patients who were diagnosed with acute ischemic stroke within the last 24 hours (n = 139)...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28320015/annals-for-hospitalists-inpatient-notes-what-do-french-wine-and-hospital-infections-have-in-common
#11
Payal K Patel, Sanjay Saint
No abstract text is available yet for this article.
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319996/oral-direct-acting-agent-therapy-for-hepatitis-c-virus-infection-a-systematic-review
#12
Oluwaseun Falade-Nwulia, Catalina Suarez-Cuervo, David R Nelson, Michael W Fried, Jodi B Segal, Mark S Sulkowski
Background: Rapid improvements in hepatitis C virus (HCV) therapy have led to the approval of multiple oral direct-acting antiviral (DAA) regimens by the U.S. Food and Drug Administration (FDA) for treatment of chronic HCV infection. Purpose: To summarize published literature on the efficacy and safety of oral DAAs for treatment of persons with chronic HCV infection. Data Sources: MEDLINE and EMBASE from inception through 1 November 2016. Study Selection: 42 English-language studies from controlled and single-group registered clinical trials of adults with HCV infection that evaluated at least 8 weeks of an FDA-approved interferon-free HCV regimen that included at least 2 DAAs...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319995/clinical-trials-of-therapeutics-for-the-prevention-of-congenital-zika-virus-disease-challenges-and-potential-solutions
#13
Alex P Salam, Amanda Rojek, Jake Dunning, Peter W Horby
Zika virus (ZIKV) infection in pregnancy is associated with adverse fetal outcomes, such as microcephaly and other congenital malformations. No therapeutic options are available to pregnant women with ZIKV infection to prevent these effects. Drug trials in pregnancy raise several scientific, ethical, and logistical challenges, which are compounded further in ZIKV because of limited knowledge of the disease pathophysiology and a product development pipeline in its infancy. We evaluate the major challenges in choosing therapeutics to prevent congenital ZIKV disease and conducting clinical trials of these treatments, with a focus on preventing congenital central nervous system malformations...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319945/glomerular-proteinuria-predicts-the-severity-of-acute-kidney-injury-in-puumala-hantavirus-induced-tubulointerstitial-nephritis
#14
Paula S Mantula, Tuula K Outinen, Jan P G Clement, Heini S A Huhtala, Ilkka H Pörsti, Antti Vaheri, Jukka T Mustonen, Satu M Mäkelä
BACKGROUND: Puumala virus (PUUV)-induced hemorrhagic fever with renal syndrome is common in many European countries. The typical renal histologic lesion is acute tubulointerstitial nephritis. We examined the type and kinetics of urine protein excretion and prognostic significance of proteinuria for the severity of acute kidney injury (AKI) in acute PUUV infection. METHODS: The amount of dipstick albuminuria at hospital admission was analyzed in 205 patients with acute PUUV infection...
March 21, 2017: Nephron
https://www.readbyqxmd.com/read/28319847/a-european-multicentre-study-on-the-comparison-of-hcv-viral-loads-between-veris-hcv-assay-and-cobas-%C3%A2-taqman-%C3%A2-hcv-test-and-realtime-hcv-assay
#15
Patrick Braun, Monica Drago, Diana Fanti, Hervé Fleury, Jörg Hofmann, Jacques Izopet, Sebastian Kühn, Alessandra Lombardi, Valeria Micheli, Karine Sauné, Pascale Trimoulet, Duncan Whittaker, Alain Artus, Daniel Rhodes
BACKGROUND: Beckman Coulter has developed the VERIS HCV Assay for use on the new fully automated DxN VERIS Molecular Diagnostic System(¥) for HCV viral load monitoring. OBJECTIVES: Evaluate the clinical performance of the new quantitative VERIS HCV Assay. STUDY DESIGN: Comparison was performed on 279 plasma specimens from HCV infected patients tested with the VERIS HCV Assay and COBAS(®) Ampliprep/COBAS(®) Taqman(®) HCV Test and 369 specimens tested with the VERIS HCV Assay and RealTime HCV Assay...
March 9, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28319846/presence-of-cytomegalovirus-in-urine-and-blood-of-pregnant-women-with-primary-infection-might-be-associated-with-fetal-infection
#16
Marie-Luce Delforge, Elena Costa, Françoise Brancart, Deborah Goldman, Isabel Montesinos, Siham Zaytouni, Arnaud Marchant, Catherine Donner
BACKGROUND: Cytomegalovirus (CMV) congenital infection can result from primary infection, reinfection or reactivation among pregnant women. The risk of vertical transmission is much higher in case of primary infection, and the transmission rate increases with gestational age. However there are still many questions about maternal markers that can predict whether the virus will be transmitted to the fetus. OBJECTIVES: To investigate the relationship between the presence and the quantity of CMV in urine and blood of women presenting a primary CMV infection during pregnancy and the presence of congenital infection in their offspring...
March 7, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28319829/evaluation-of-the-pharmacokinetics-of-imipenem-following-regional-limb-perfusion-using-the-saphenous-and-the-cephalic-veins-in-standing-horses
#17
G Kelmer, A J Tatz, E Kdoshim, M Britzi, G Segev
This prospective experimental study goal was to determine the pharmacokinetics of imipenem after intravenous regional limb perfusion (IV-RLP) in standing horses. Nine horses participated in the study; that was approved by the University Animal Care and Use Committee. One thoracic limb or one pelvic limb of each horse was randomly selected. After the veins were catheterized, an Esmarch bandage tourniquet was applied and the catheter was injected with a solution containing 500mg of imipenem. Synovial fluid samples were collected from the fetlock joint and blood samples were collected from the jugular vein...
February 24, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28319817/indoor-air-quality-of-low-and-middle-income-urban-households-in-durban-south-africa
#18
Nkosana Jafta, Lars Barregard, Prakash M Jeena, Rajen N Naidoo
INTRODUCTION: Elevated levels of indoor air pollutants may cause cardiopulmonary disease such as lower respiratory infection, chronic obstructive lung disease and lung cancer, but the association with tuberculosis (TB) is unclear. So far the risk estimates of TB infection or/and disease due to indoor air pollution (IAP) exposure are based on self-reported exposures rather than direct measurements of IAP, and these exposures have not been validated. OBJECTIVE: The aim of this paper was to characterize and develop predictive models for concentrations of three air pollutants (PM10, NO2 and SO2) in homes of children participating in a childhood TB study...
March 15, 2017: Environmental Research
https://www.readbyqxmd.com/read/28319793/early-response-of-wheat-antioxidant-system-with-special-reference-to-fusarium-head-blight-stress
#19
Valentina Spanic, Marija Viljevac Vuletic, Ivan Abicic, Tihana Marcek
Fusarium head blight (FHB) is a destructive fungal disease of wheat (Triticum aestivum L.) that causes significant grain yield losses and end-use quality reduction associated with contamination by the mycotoxin deoxynivalenol (DON). Three winter wheat varieties ('Vulkan', 'Kraljica' and 'Golubica') were screened for FHB resistance using artificial inoculation technique under field conditions. The aim of this study was to examine a relationship between FHB resistance and the effectiveness of enzyme antioxidant system of wheat varieties under different sampling times (3, 15, 24, 48, 96, 120 and 336 hai)...
March 14, 2017: Plant Physiology and Biochemistry: PPB
https://www.readbyqxmd.com/read/28319790/within-host-rna-virus-persistence-mechanisms-and-consequences
#20
REVIEW
Richard E Randall, Diane E Griffin
In a prototypical response to an acute viral infection it would be expected that the adaptive immune response would eliminate all virally infected cells within a few weeks of infection. However many (non-retrovirus) RNA viruses can establish 'within host' persistent infections that occasionally lead to chronic or reactivated disease. Despite the importance of 'within host' persistent RNA virus infections, much has still to be learnt about the molecular mechanisms by which RNA viruses establish persistent infections, why innate and adaptive immune responses fail to rapidly clear these infections, and the epidemiological and potential disease consequences of such infections...
March 17, 2017: Current Opinion in Virology
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