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https://www.readbyqxmd.com/read/27891260/intravenous-vitamin-c-administered-as-adjunctive-therapy-for-recurrent-acute-respiratory-distress-syndrome
#1
Amit Bharara, Catherine Grossman, Daniel Grinnan, Aamer Syed, Bernard Fisher, Christine DeWilde, Ramesh Natarajan, Alpha A Berry Fowler
This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#2
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27864449/what-are-the-critical-steps-in-processing-blood-cultures-a-prospective-audit-evaluating-current-practice-of-reporting-blood-cultures-in-a-centralised-laboratory-serving-secondary-care-hospitals
#3
Manjula Meda, James Clayton, Reela Varghese, Jayakeerthi Rangaiah, Clive Grundy, Farnaz Dashti, David Garner, Katherine Groves, Karen Fitzmaurice, E Hutley
AIMS: To assess current procedures of processing positive blood cultures against national standards with an aim to evaluate its clinical impact and to determine the utility of currently available rapid identification and susceptibility tests in processing of blood cultures. METHODS: Blood cultures from three secondary care hospitals, processed at a centralised laboratory, were prospectively audited. Data regarding processing times, communication with prescribers, changes to patient management and mortality within 30 days of a significant blood culture were collected in a preplanned pro forma for a 4-week period...
November 18, 2016: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27863531/effects-of-continuous-renal-replacement-therapy-on-linezolid-pharmacokinetic-pharmacodynamics-a-systematic-review
#4
Gianluca Villa, Paola Di Maggio, A Raffaele De Gaudio, Andrea Novelli, Riccardo Antoniotti, Enrico Fiaccadori, Chiara Adembri
BACKGROUND: Major alterations in linezolid pharmacokinetic/pharmacodynamic (PK/PD) parameters might be expected in critically ill septic patients with acute kidney injury (AKI) who are undergoing continuous renal replacement therapy (CRRT). The present review is aimed at describing extracorporeal removal of linezolid and the main PK-PD parameter changes observed in critically ill septic patients with AKI, who are on CRRT. METHOD: Citations published on PubMed up to January 2016 were systematically reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement...
November 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#5
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27852379/-investigation-of-molecular-epidemiology-of-methicillin-resistant-staphylococcus-aureus-in-department-of-critical-care-medicine
#6
Y X Qin, Q D Li, X Y Wan, L Y Bi, J Wang
Objective: To investigate the feature of antimicrobial resistance, homology and other molecular epidemiology of methicillin-resistant staphylococcus aureus(MRSA) in Department of Critical Care Medicine(ICU). Methods: From October 2010 to December 2011, 149 strains of MRSA were collected and identified through sputum culture of patients from 10 ICUs of 10 teaching hospitals distributed in 9 chinese central city of China. Susceptibility testing to 18 kinds of antibiotic was performed, the method of pulsed field gel electrophoresis (PFGE) was used to analyze the homology, and the technique of multilocus sequencing typing (MLST) was used to identify the sequence type (ST)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27846022/postoperative-care-in-endoscopic-sinus-surgery-a-critical-review
#7
Philippe Eloy, Peter Andrews, Anne-Lise Poirrier
PURPOSE OF REVIEW: Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies...
November 14, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27845826/withdrawn-interventions-for-ear-discharge-associated-with-grommets-ventilation-tubes
#8
REVIEW
Louise Vaile, Tim Williamson, Angus Waddell, Gordon J Taylor
BACKGROUND: The insertion of grommets (also known as ventilation or tympanostomy tubes) is one of the most common surgical procedures performed on children. Postoperative otorrhoea (discharge) is the most common complication with a reported incidence ranging from 10% to 50%. In the UK, many ENT surgeons treat with topical antibiotics/steroid combinations, but general practitioners, mainly through fears of ototoxicity, are unlikely to prescribe these and choose systemic broad-spectrum antibiotics...
November 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27837233/critically-ill-patients-demonstrate-large-interpersonal-variation-in-intestinal-microbiota-dysregulation-a-pilot-study
#9
Jacqueline M Lankelma, Lonneke A van Vught, Clara Belzer, Marcus J Schultz, Tom van der Poll, Willem M de Vos, W Joost Wiersinga
PURPOSE: The intestinal microbiota has emerged as a virtual organ with essential functions in human physiology. Antibiotic-induced disruption of the microbiota in critically ill patients may have a negative influence on key energy resources and immunity. We set out to characterize the fecal microbiota composition in critically ill patients both with and without sepsis and to explore the use of microbiota-derived markers for clinical outcome measurements in this setting. METHODS: In this prospective observational cohort study we analyzed the fecal microbiota of 34 patients admitted to the intensive care unit...
November 11, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27835840/correlation-between-the-number-of-pro-ala-repeats-in-the-emra-homologue-of-acinetobacter-baumannii-and-resistance-to-netilmicin-tobramycin-imipenem-and-ceftazidime
#10
Alicja Nowak-Zaleska, Miłosz Wieczór, Jacek Czub, Łukasz Nierzwicki, Roman Kotłowski, Agnieszka Mikucka, Eugenia Gospodarek
Acinetobacter baumannii coccobacilli are dangerous to patients in intensive care units because of their multidrug resistance to antibiotics, developed mainly in the past decade. This study aimed to examine whether there is a significant correlation between the number of Pro-Ala repeats in the CAP01997 protein, the EmrA homologue of A. baumannii, and resistance to antibiotics. A total of 79 multidrug-resistant A. baumannii strains isolated from patients were analysed. Resistance to antibiotics was determined on Mueller-Hinton agar plates using the Kirby-Bauer disk diffusion method...
December 2016: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#11
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27815777/staphylococcus-aureus-carriage-at-admission-predicts-early-onset-pneumonia-after-burn-trauma
#12
A Fournier, P Voirol, M Krähenbühl, C-L Bonnemain, C Fournier, E Dupuis-Lozeron, O Pantet, J-L Pagani, J-P Revelly, F Sadeghipour, P Eggimann, Y-A Que
Early-onset pneumonia (EOP) is frequent after burn trauma, increasing morbidity in the critical resuscitation phase, which may preclude early aggressive management of burn wounds. Currently, however, preemptive treatment is not recommended. The aim of this study was to identify predictive factors for EOP that may justify early empirical antibiotic treatment. Data for all burn patients requiring ≥4 h mechanical ventilation (MV) who were admitted between January 2001 and October 2012 were extracted from the hospital's computerized information system...
November 4, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27810974/using-a-simple-point-prevalence-survey-to-define-appropriate-antibiotic-prescribing-in-hospitalised-children-across-the-uk
#13
Myriam Gharbi, Katja Doerholt, Stefania Vergnano, Julia Anna Bielicki, Stéphane Paulus, Esse Menson, Andrew Riordan, Hermione Lyall, Sanjay Valabh Patel, Jolanta Bernatoniene, Ann Versporten, Maggie Heginbothom, Herman Goossens, Mike Sharland
BACKGROUND: The National Health Service England, Commissioning for Quality and Innovation for Antimicrobial Resistance (CQUIN AMR) aims to reduce the total antibiotic consumption and the use of certain broad-spectrum antibiotics in secondary care. However, robust baseline antibiotic use data are lacking for hospitalised children. In this study, we aim to describe, compare and explain the prescription patterns of antibiotics within and between paediatric units in the UK and to provide a baseline for antibiotic prescribing for future improvement using CQUIN AMR guidance...
November 3, 2016: BMJ Open
https://www.readbyqxmd.com/read/27804077/the-italian-society-of-internal-medicine-choosing-wisely-campaign
#14
Nicola Montano, Giorgio Costantino, Giovanni Casazza, Rodolfo Sbrojavacca, Marco Vincenzo Lenti, Lorenzo Falsetti, Annasanta Guzzo, Raffaele Majo, Francesco Perticone, Gino Roberto Corazza
Appropriateness is one of the critical aspects of medicine. For this reason, the Italian Society of Internal Medicine (SIMI) decided to adhere to the Choosing Wisely Campaign. A bottom-up approach was chosen. All the recommendations published in the US and Canadian Choosing Wisely campaign have been screened, and an e-mail was sent to all the SIMI members for new suggestions. The thirty interventions that were judged as the highest priority by a committee were sent to all the SIMI members for voting. The first procedures selected were then revised, and constituted the five points of the SIMI choosing wisely campaign...
December 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27800290/antibiogram-of-medical-intensive-care-unit-at-tertiary-care-hospital-setting-of-pakistan
#15
Aayesha Qadeer, Aftab Akhtar, Qurat Ul Ain, Shoab Saadat, Salman Mansoor, Salman Assad, Wasib Ishtiaq, Abid Ilyas, Ali Y Khan, Yousaf Ajam
OBJECTIVE:  To determine the frequency of micro-organisms causing sepsis as well as to determine the antibiotic susceptibility and resistance of microorganisms isolated in a medical intensive care unit. MATERIALS AND METHODS:  This is a cross-sectional analysis of 802 patients from a medical intensive care unit (ICU) of Shifa International Hospital, Islamabad, Pakistan over a one-year period from August 2015 to August 2016. Specimens collected were from blood, urine, endotracheal secretions, catheter tips, tissue, pus swabs, cerebrospinal fluid, ascites, bronchoalveolar lavage (BAL), and pleural fluid...
September 29, 2016: Curēus
https://www.readbyqxmd.com/read/27790429/act-fast-as-time-is-less-high-faecal-carriage-of-carbapenem-resistant-enterobacteriaceae-in-critical-care-patients
#16
Sanjith Saseedharan, Manisa Sahu, Edwin Joseph Pathrose, Sarita Shivdas
INTRODUCTION: Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. AIM: To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27778318/oral-hygiene-care-for-critically-ill-patients-to-prevent-ventilator-associated-pneumonia
#17
REVIEW
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27776162/incidence-clinical-outcome-and-risk-factors-of-intensive-care-unit-infections-in-the-lagos-university-teaching-hospital-luth-lagos-nigeria
#18
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
https://www.readbyqxmd.com/read/27771978/challenges-and-opportunities-in-the-treatment-of-ventilator-associated-pneumonia
#19
Matthew P Schreiber, Andrew F Shorr
Ventilator-associated pneumonia (VAP) is a distinct clinical entity characterized by an onset after 48 hours of the application of mechanical ventilation (MV). Protocols exist to aid in the prevention of VAP, but this infection carries a devastating impact on patient morbidity and potentially mortality. Areas covered: In this review we present key concepts from existing guidelines to aid clinicians. Challenges remain in defining this disease and, most importantly appropriate empiric antimicrobial treatment is the main determinant of outcome...
October 24, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27771302/blurred-lines-dysbiosis-and-probiotics-in-the-intensive-care-unit
#20
Lee E Morrow, Paul Wischmeyer
Clinicians have traditionally dichotomized bacteria as friendly commensals or harmful pathogens. However, the line separating the two has become blurred with the recognition that the intestinal microbiome is a complex entity wherein species can shift sides - from friend to foe and back again - based on crucial factors in their local environment. Significant disruptions in the homeostasis of the microbiome, a phenomenon called 'dysbiosis,' is increasingly associated with a host of untoward effects. Intensive care unit patients are at high risk for dysbiosis given high rates of antibiotic use, acute changes in diet, and the stress of critical illness...
October 19, 2016: Chest
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