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https://www.readbyqxmd.com/read/29228381/the-etiology-and-impact-of-co-infections-in-children-hospitalized-with-community-acquired-pneumonia
#1
Vikki G Nolan, Sandra R Arnold, Anna M Bramley, Krow Ampofo, Derek J Williams, Carlos G Grijalva, Wesley H Self, Evan J Anderson, Richard G Wunderink, Kathryn M Edwards, Andrew T Pavia, Seema Jain, Jonathan A McCullers
Background: Recognition that co-infections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance. Methods: We analyzed data from 2219 children hospitalized with CAP and compared demographics, clinical characteristics, and outcomes between groups with viruses alone, bacteria alone, or co-infections. We also assessed the frequency of selected pairings of co-detected pathogens and their clinical characteristics...
December 8, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29228380/elderly-versus-nonelderly-patients-with-invasive-aspergillosis-in-the-icu-a-comparison-and-risk-factor-analysis-for-mortality-from-the-aspicu-cohort
#2
D K Matthaiou, G Dimopoulos, F S Taccone, P Bulpa, A M Van den Abeele, B Misset, W Meersseman, H Spapen, T Cardoso, P E Charles, D Vogelaers, S Blot
Data regarding the epidemiology and diagnosis of invasive aspergillosis in the critically ill population are limited, with data regarding elderly patients (≥75 years old) even scarcer. We aimed to further compare the epidemiology, characteristics and outcome of elderly versus nonelderly critically ill patients with invasive aspergillosis (IA) Prospective, international, multicenter observational study (AspICU) including adult intensive care unit (ICU) patients, with a culture and/or direct examination and/or histopathological sample positive for Aspergillus spp...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#3
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29228133/regional-epidemiology-of-methicillin-resistant-staphylococcus-aureus-among-adult-intensive-care-unit-patients-following-state-mandated-active-surveillance
#4
Michael Y Lin, Mary K Hayden, Rosie D Lyles, Karen Lolans, Louis F Fogg, Alexander J Kallen, Stephen G Weber, Robert A Weinstein, William E Trick
Background: In 2007, Illinois became the first state in the United States to mandate active surveillance of methicillin-resistant Staphylococcus aureus (MRSA). The Illinois law applies to intensive care unit (ICU) patients; contact precautions are required for patients found to be MRSA-colonized. However, the effectiveness of a legislated "search and isolate" approach to reduce MRSA burden among critically ill patients is uncertain. We evaluated whether the prevalence of MRSA colonization declined in the 5 years after the start of mandatory active surveillance...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29227335/usefulness-of-the-braden-scale-in-intensive-care-units-a-study-based-on-electronic-health-record-data
#5
Yi Na Han, Jung Eun Choi, Yin Ji Jin, Tai Xian Jin, Sun-Mi Lee
Nurses working in intensive care units have expressed concern that some categories of the Braden scale such as activity and nutrition are not suitable for intensive care unit patients. Upon examining the validity of the Braden scale using the electronic health data, we found relatively low predictability of the tool. Risk factors from the sensory perception and activity categories were not associated with risk of pressure ulcers.
December 8, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#6
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29226974/acute-bronchiolitis-influence-of-viral-co-infection-in-infants-hospitalized-over-12-consecutive-epidemic-seasons
#7
Laura Petrarca, Raffaella Nenna, Antonella Frassanito, Alessandra Pierangeli, Salvatore Leonardi, Carolina Scagnolari, Guido Antonelli, Paola Papoff, Corrado Moretti, Fabio Midulla
Bronchiolitis is the first lower respiratory tract viral infection manifesting in infants younger than 12 months of age. Our aim was to evaluate clinical and serological differences in infants with bronchiolitis from a single or from multiple viruses. Our secondary aim was to investigate differences in recurrent wheezing episodes after 12-24-36 months of follow-up. We reviewed the clinical records for 486 full-term infants hospitalized for bronchiolitis with at least one virus detected in the nasopharyngeal aspirate...
December 11, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/29226740/do-infants-in-the-neonatal-intensive-care-unit-diagnosed-with-urinary-tract-infection-need-a-routine-voiding-cystourethrogram
#8
Dustin D Flannery, Erik Brandsma, Judy Saslow, Amy B Mackley, David A Paul, Zubair H Aghai
OBJECTIVE: To determine if infants diagnosed with urinary tract infection (UTI) in the neonatal intensive care unit (NICU) require a routine voiding cystourethrogram (VCUG). STUDY DESIGN: Retrospective data analysis from three centers for infants admitted to the NICU born between 2000 and 2013 and diagnosed with UTI. RESULTS: One hundred twenty-six infants from three centers were diagnosed with UTI during their hospitalization. Renal ultrasound (RUS) was performed in 115 infants (91...
December 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29226131/risk-factors-of-delirium-in-sequential-sedation-patients-in-intensive-care-units
#9
Jie Yang, Yongfang Zhou, Yan Kang, Binbin Xu, Peng Wang, Yinxia Lv, Zhen Wang
Background: Delirium is a primary adverse event in ventilated patients who receive long-term monosedative treatment. Sequential sedation may reduce these adverse effects. This study evaluated risk factors for delirium in sequential sedation patients. Methods: A total of 141 patients who underwent sequential sedation were enrolled. Delirium was diagnosed using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale. Univariate and multivariate Cox proportional hazards regressions were used to predict risk factors...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29226017/buprenorphine-for-medication-assisted-treatment-of-opioid-use-disorder-in-pregnancy-relationship-to-neonatal-opioid-withdrawal-syndrome
#10
Niraj R Chavan, Kristin B Ashford, Amanda T Wiggins, Michelle R Lofwall, Agatha S Critchfield
Objective  To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design  We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups-pregnancies with versus without NOWS...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#11
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#12
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29225783/a-study-on-the-efficacy-of-apache-iv-for-predicting-mortality-and-length-of-stay-in-an-intensive-care-unit-in-iran
#13
Mohammad Ghorbani, Haleh Ghaem, Abbas Rezaianzadeh, Zahra Shayan, Farid Zand, Reza Nikandish
Background: Clinical assessment of disease severity is an important part of medical practice for prediction of mortality and morbidity in Intensive Care Unit (ICU). A disease severity scoring system can be used as guidance for clinicians for objective assessment of disease outcomes and estimation of the chance of recovery. This study aimed to evaluate the hypothesis that the mortality and length of stay in emergency ICUs predicted by APACHE-IV is different to the real rates of mortality and length of stay observed in our emergency ICU in Iran...
2017: F1000Research
https://www.readbyqxmd.com/read/29225477/molecular-evaluation-of-colistin-resistant-gene-expression-changes-in-acinetobacter-baumannii-with-real-time-polymerase-chain-reaction
#14
Shahriar Sepahvand, Mohammad Ali Davarpanah, Amir Roudgari, Abbas Bahador, Vajihe Karbasizade, Zahra Kargar Jahromi
Background: Acinetobacter baumannii is an important human pathogen which has recently gained increased attention due to the occurrence of drug-resistant nosocomial infections in patients suffering from immune system disorders, and those in hospital intensive care units. The aim of this research was to identify and isolate A. baumannii strains resistant to colistin, determine antibiotic resistance pattern of this bacteria, investigate the presence of colistin-resistant genes, and finally assess the effect of expression changes in pmrA and pmrB genes resistant to A...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29225343/advances-in-the-understanding-and-treatment-of-sepsis-induced-immunosuppression
#15
REVIEW
Fabienne Venet, Guillaume Monneret
Sepsis is defined as a life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Sepsis can induce acute kidney injury and multiple organ failures and represents the most common cause of death in the intensive care unit. Sepsis initiates a complex immune response that varies over time, with the concomitant occurrence of both pro-inflammatory and anti-inflammatory mechanisms. As a result, most patients with sepsis rapidly display signs of profound immunosuppression, which is associated with deleterious consequences...
December 11, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29225152/a-randomized-controlled-trial-of-intra-aortic-adenosine-infusion-before-release-of-the-aortic-cross-clamp-during-coronary-artery-bypass-surgery
#16
Amany Ammar, Khaled Mahmoud, Ahmed Elkersh, Zeinab Kasemy
OBJECTIVES: To assess the feasibility, safety, and potential useful effect of adenosine as a postconditioning agent in patients undergoing coronary artery bypass grafting surgeries. DESIGN: Prospective randomized controlled study. SETTING: University hospital. PARTICIPANTS: The study comprised 60 patients scheduled for coronary artery bypass grafting surgery. INTERVENTIONS: Adenosine (postconditioning group) or placebo (control group)...
December 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#17
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224772/resolution-of-vocal-fold-immobility-in-preterm-infants
#18
Jad Jabbour, Thomas Robey
INTRODUCTION: Vocal fold immobility (VFI) is an important sequela of preterm birth due to patent ductus arteriosus (PDA) ligation and invasive ventilation. A minority of these patients experience VFI resolution. The purpose of this study is to determine factors associated with VFI resolution in preterm infants. METHODS: This is a case control study of preterm (<37 weeks gestation) infants admitted to a metropolitan Level IV neonatal intensive care unit from 2006 to 2012...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29224257/models-of-care-for-non-invasive-ventilation-in-the-acute-copd-comparison-of-three-tertiary-hospitals-act3-study
#19
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29224247/cortisol-and-blood-pressure-levels-decreased-in-fathers-during-the-first-hour-of-skin-to-skin-contact-with-their-premature-babies
#20
Natalia Varela, Réjean Tessier, George Tarabulsy, Tamarha Pierce
AIM: Premature birth is an extremely stressful experience. In 2013 to 2014 we explored the physiological stress responses of fathers during their first skin-to-skin contact with their new baby. METHODS: We recruited 49 fathers whose partners had given birth to a premature baby of up to 33 weeks and three days. The study, in the neonatal intensive care unit (NICU) of a Quebec hospital, measured the physiological stress responses of the fathers before and after they first experienced skin-to-skin contact with their new baby...
December 9, 2017: Acta Paediatrica
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