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https://www.readbyqxmd.com/read/28630239/an-unusual-case-of-escherichia-coli-o157-h7-infection-with-pseudomembranous-colitis-like-lesions-associated-with-haemolytic-uraemic-syndrome-and-neurological-sequelae
#1
James Kennedy, Lauren Simmonds, Robert Orme, Warren Doherty
A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28627952/clinical-efficacy-of-piperacillin-tazobactam-in-the-treatment-of-complicated-skin-and-soft-tissue-infections
#2
Kohei Takimoto, Qianzhi Wang, Daisuke Suzuki, Mitsuya Katayama, Yoshiro Hayashi
Introduction Complicated skin and soft tissue infections (cSSTIs) are skin and soft tissue infections (SSTIs) that involve deep soft tissue. cSSTIs often require surgical intervention and/or hospitalization. cSSTIs are associated with significant mortality and morbidity, and carry a significant burden on health care systems. Piperacillin/tazobactam has been regarded as a standard treatment for cSSTIs because of its antibiotic spectrum, safety and clinical efficacy. Several antibiotics, as compared to piperacillin/tazobactam, have been evaluated in the treatment of cSSTIs...
June 19, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28622210/serotonin-syndrome-following-combined-administration-of-dopaminergic-and-noradrenergic-agents-in-a-patient-with-akinetic-mutism-after-frontal-intracerebral-hemorrhage-a-case-report
#3
Dae Geun Jeon, Yong Wook Kim, Na Young Kim, Jung Hyun Park
BACKGROUND: Serotonin syndrome (SS) is a potentially life-threatening condition that can be caused by use of proserotonergic drugs. Several studies have reported that combined administration of various medications may induce SS. We report a case of SS in a patient who was being treated with dopaminergic and noradrenergic drugs. CASE PRESENTATION: A 55-year-old man with a right frontal intracerebral hemorrhage extending to the left cerebral hemisphere presented with clinical features of akinetic mutism...
June 16, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28619041/assessment-of-short-and-long-term-outcomes-of-diabetes-patient-education-using-the-health-education-impact-questionnaire-heiq
#4
Ditte Hjorth Laursen, Karl Bang Christensen, Ulla Christensen, Anne Frølich
BACKGROUND: Type 2 diabetes is a progressive chronic illness that will affect more than 500 million people worldwide by 2030. It is a significant cause of morbidity and mortality. Finding the right care management for diabetes patients is necessary to effectively address the growing population of affected individuals and escalating costs. Patient education is one option for improving patient self-management. However, there are large discrepancies in the outcomes of such programs and long-term data are lacking...
June 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28618896/managing-risk-during-care-transitions-when-approaching-end-of-life-a-qualitative-study-of-patients-and-health-care-professionals-decision-making
#5
Maureen A Coombs, Roses Parker, Kay de Vries
BACKGROUND: Increasing importance is being placed on the coordination of services at the end of life. AIM: To describe decision-making processes that influence transitions in care when approaching the end of life. DESIGN: Qualitative study using field observations and longitudinal semi-structured interviews. SETTING/PARTICIPANTS: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28612748/novel-treatment-strategies-in-rheumatoid-arthritis
#6
REVIEW
Gerd R Burmester, Janet E Pope
New treatment strategies have substantially changed the course of rheumatoid arthritis. Many patients can achieve remission if the disease is recognised early and is treated promptly and continuously; however, some individuals do not respond adequately to treatment. Rapid diagnosis and a treat-to-target approach with tight monitoring and control, can increase the likelihood of remission in patients with rheumatoid arthritis. In this Series paper, we describe new insights into the management of rheumatoid arthritis with targeted therapy approaches using classic and novel medications, and outline the potential effects of precision medicine in this challenging disease...
June 10, 2017: Lancet
https://www.readbyqxmd.com/read/28610756/crossing-a-line-a-narrative-of-risk-taking-by-older-women-serving-as-caregivers
#7
Jennifer L Womack, Margareta Lilja, Gunilla Isaksson
BACKGROUND: Caregiving carried out by adults for other adults is increasing around the world as the demographics of many industrialized countries shift toward an older population with escalating care needs toward the end of life. Although much has been written about caregiving, few studies document the experiences of providing care as narrated by the caregivers. AIM: To explore the everyday experiences of older adults serving as primary informal caregivers to significant others...
April 2017: Journal of Aging Studies
https://www.readbyqxmd.com/read/28608437/-we-don-t-do-it-for-the-money-%C3%A2-the-scale-and-reasons-of-poverty-pay-among-frontline-long-term-care-workers-in-england
#8
Shereen Hussein
Demographic trends escalate the demands for formal long-term care (LTC) in the majority of the developed world. The LTC workforce is characterised by its very low wages, the actual scale of which is less well known. This article investigates the scale of poverty-pay in the feminised LTC sector and attempts to understand the perceived reasons behind persisting low wages in the sector. The analysis makes use of large national workforce pay data and a longitudinal survey of care workers, as well as interviews with key stakeholders in the sector...
June 12, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28606970/the-dynamics-of-response-as-measured-by-multiple-composite-outcome-tools-in-the-tight-control-of-inflammation-in-early-psoriatic-arthritis-ticopa-trial
#9
Laura C Coates, Farrouq Mahmood, Paul Emery, Philip G Conaghan, Philip S Helliwell
BACKGROUND: We aimed to evaluate the dynamics of treatment response with different composite measures in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial. METHODS: Participants with early disease-modifying antirheumatic drug-naïve psoriatic arthritis (PsA) were randomised 1:1 to either tight control (TC; 4 weekly review with therapy escalation if criteria not met) or standard care (SC; 12 weekly review). We calculated modified versions of the Psoriatic ArthritiS Disease Activity Score (PASDAS), Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Composite scorE (GRACE) and Composite Psoriatic Disease Activity Index (CPDAI) at baseline and 12 weekly to 48 weeks by blinded assessor...
June 12, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28606073/associations-between-patient-factors-and-adverse-events-in-the-home-care-setting-a-secondary-data-analysis-of-two-canadian-adverse-event-studies
#10
Nancy A Sears, Régis Blais, Michael Spinks, Michèle Paré, G Ross Baker
BACKGROUND: Early identification of patients at who have a higher risk for the occurrence of harm can provide patient safety improvement opportunities. Patient factors contribute to adverse event occurrence. The study aim was to identify a single, parsimonious model of home care patient factors that, regardless of location and differences in home care program management and design factors, could provide a means of locating patients at higher and lower risk of harm. METHODS: Split modeling using secondary analyses of data from two recent Canadian home care patient safety studies was undertaken...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28601833/targeted-simplification-versus-antipseudomonal-broad-spectrum-beta-lactams-in-patients-with-bloodstream-infections-due-to-enterobacteriaceae-simplify-a-study-protocol-for-a-multicentre-open-label-phase-iii-randomised-controlled-non-inferiority-clinical-trial
#11
Luis Eduardo López-Cortés, Clara Rosso-Fernández, María Núñez-Núñez, Lucía Lavín-Alconero, José Bravo-Ferrer, Ángel Barriga, Mercedes Delgado, Carmen Lupión, Pilar Retamar, Jesús Rodríguez-Baño
INTRODUCTION: Within the context of antimicrobial stewardship programmes, de-escalation of antimicrobial therapy is one of the proposed strategies for reducing the unnecessary use of broad-spectrum antibiotics (BSA). The empirical treatment of nosocomial and some healthcare-associated bloodstream infections (BSI) frequently includes a beta-lactam with antipseudomonal activity as monotherapy or in combination with other drugs, so there is a great opportunity to optimise the empirical therapy based on microbiological data...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28599887/phase-i-trial-of-cediranib-in-combination-with-cisplatin-and-pemetrexed-in-chemo-naive-patients-with-unresectable-malignant-pleural-mesothelioma-swog-s0905
#12
Anne S Tsao, James Moon, Ignacio I Wistuba, Nicholas J Vogelzang, Gregory P Kalemkerian, Mary W Redman, David R Gandara, Karen Kelly
BACKGROUND: In malignant pleural mesothelioma (MPM), targeting angiogenesis, with cediranib, a vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor (PDGFR) inhibitor, may have therapeutic potential. METHODS: S0905 phase I combined cediranib (2 dose cohorts 30 mg and 20 mg daily) with cisplatin-pemetrexed for 6 cycles followed by maintenance cediranib in unresectable chemo-naïve MPM patients of any histologic subtype. The primary endpoint established the MTD in combination with cisplatin-pemetrexed in a dose de-escalation schema...
June 6, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28599142/opioid-pharmacovigilance-a-clinical-social-history-of-the-changes-in-opioid-prescribing-for-patients-with-co-occurring-chronic-non-cancer-pain-and-substance-use
#13
Kelly R Knight, Margot Kushel, Jamie S Chang, Kara Zamora, Rachel Ceasar, Emily Hurstak, Christine Miaskowski
There is growing concern among US-based clinicians, patients, policy makers, and in the media about the personal and community health risks associated with opioids. Perceptions about the efficacy and appropriateness of opioids for the management of chronic non-cancer pain (CNCP) have dramatically transformed in recent decades. Yet, there is very little social scientific research identifying the factors that have informed this transformation from the perspectives of prescribing clinicians. As part of an on-going ethnographic study of CNCP management among clinicians and their patients with co-occurring substance use, we interviewed 23 primary care clinicians who practice in safety-net clinical settings...
May 23, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28590945/addressing-the-global-zika-epidemic-locally-an-interprofessional-model-of-universal-screening-at-one-center
#14
Rosha N Forman, Pooja K Mehta, Kettie R Louis, Molly K Finneseth, Christina D Yarrington
Escalating evidence for the fetal impact of Zika virus infection required a change in care by all prenatal providers. This article describes an effective model of rapid implementation of universal prenatal screening at one hospital and its network of community health centers for a large and diverse immigrant population exploring the challenges, experiences, and lessons learned. Implementation of national recommendations required a workflow change, challenging a system with a heterogeneity of settings and providers...
June 6, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28588119/high-flow-nasal-cannula-utilization-in-pediatric-critical-care
#15
Kristen D Coletti, Dayanand N Bagdure, Linda K Walker, Kenneth E Remy, Jason W Custer
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. METHODS: This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from October 1, 2011 to October 31, 2013...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#16
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28579084/j%C3%A3-vea-consensus-guidelines-for-the-treatment-of-candida-peritonitis-and-other-intra-abdominal-fungal-infections-in-non-neutropenic-critically-ill-adult-patients
#17
Javier Pemán, Gerardo Aguilar, Juan Carlos Valía, Miguel Salavert, David Navarro, Rafael Zaragoza
BACKGROUND: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. AIMS: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection...
May 31, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28578550/ventilator-associated-pneumonia-the-role-of-emerging-diagnostic-technologies
#18
Marin H Kollef, Carey-Ann D Burnham
Antibiotic resistance has emerged as a key determinant of outcome in patients with serious infections along with the virulence of the underlying pathogen. Within the intensive care unit (ICU) setting, ventilator-associated pneumonia (VAP) is a common nosocomial infection that is frequently caused by multidrug-resistant bacteria. Antimicrobial resistance is a growing challenge in the care of critically ill patients. Escalating rates of antibiotic resistance add substantially to the morbidity, mortality, and cost related to infection in the ICU...
June 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28576754/stroke-avoidance-for-children-in-rep%C3%A3%C2%BAblica-dominicana-sacred-protocol-for-a-prospective-study-of-stroke-risk-and-hydroxyurea-treatment-in-sickle-cell-anemia
#19
Neelum D Jeste, Luisanna M Sánchez, Gabriela S Urcuyo, Melissa E Bergés, Judy P Luden, Susan E Stuber, Teresa S Latham, Rafael Mena, Rosa M Nieves, Russell E Ware
BACKGROUND: In the Dominican Republic, where the burden of sickle cell anemia (SCA) is high, many children lack access to routine screening and preventative care. Children with SCA are at risk for stroke, an event that leads to significant morbidity and mortality. In the United States, screening via transcranial Doppler (TCD) identifies children with SCA at highest stroke risk, allowing early intervention with blood transfusions. The need for indefinite transfusions for primary stroke prevention limits their practicality in limited-resource countries...
June 2, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28571022/therapeutic-use-exemptions
#20
David Gerrard, Andrew Pipe
The introduction, in 2004, of the World Anti-Doping Code and a standardized "prohibited list" of substances and methods proscribed in sport represented a consistent, international response to the escalating challenge of drug misuse in contemporary sport. Simultaneously, it was recognized that athletes experiencing illness or injury might legitimately require the use of "prohibited" medications or procedures, and the concept of the "therapeutic use exemption" (TUE) was introduced. The mechanisms of the TUE process are carefully defined and described in a specific WADA "international standard" (IS)...
2017: Medicine and Sport Science
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