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https://www.readbyqxmd.com/read/29143474/chronic-intestinal-pseudo-obstruction-progress-in-management
#1
REVIEW
G Di Nardo, T B Karunaratne, S Frediani, R De Giorgio
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of gastrointestinal dysmotility (often due to derangement of the innervation/smooth muscle/interstitial cells of Cajal) with recurrent episodes of intestinal subocclusion mimicking a mechanical obstruction. Because of its complexity and heterogeneity, CIPO is often misdiagnosed or remains unrecognized until advanced stages. Management is a critical aspect in CIPO patient care. So far, most prokinetic drugs have not proven efficacy in restoring intestinal propulsion, thus nutritional support, fluid/electrolyte replacement, and antibiotics are the mainstay of treatment...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#2
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132794/saccharomyces-cerevisiae-fungemia-after-probiotic-treatment-in-an-intensive-care-unit-patient
#3
I Kara, F Yıldırım, Ö Özgen, S Erganiş, M Aydoğdu, M Dizbay, G Gürsel, A Kalkanci
Saccharomyces cerevisiae is a common colonizer of the human gastrointestinal system as a benign organism. Enteral supplementation of this yeast as a probiotic product is effective in the treatment of antibiotic associated diarrhae. In rare occasions it can cause invasive infections. We present two fungemia cases in an intensive care unit following probiotic treatment containing S. boulardii. We are warning the safety of probiotic treatment in critically ill patients.
November 10, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/29129539/leptospirosis-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#4
REVIEW
Juan Ignacio Silesky Jiménez, Jorge Luis Hidalgo Marroquin, Guy A Richards, Pravin Amin
Leptospirosis is a zoonosis caused by a gram negative aerobic spirochete of the genus Leptospira. It is acquired by contact with urine or reproductive fluids from infected animals, or by inoculation from contaminated water or soil. The disease has a global distribution, mainly in tropical and subtropical regions that have a humid, rainy climate and is also common in travelers returning from these regions. Clinical suspicion is critical for the diagnosis and it should be included in the differential diagnosis of any patient with a febrile hepatorenal syndrome in, or returning from endemic regions...
November 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29125177/surgical-management-of-impalement-injuries-to-the-trunk-of-dogs-a-multicentre-retrospective-study
#5
M Matiasovic, Z J Halfacree, A Moores, P Nelissen, S Woods, B Dean, G Chanoit, D C Barnes
OBJECTIVES: To review a large series of dogs referred for treatment of traumatic impalement injuries to the thorax and/or abdomen and to report aetiologies, injury characteristics, management and long-term outcomes. MATERIALS AND METHODS: Previously collected data on dogs that were surgically treated for impalement injuries to the trunk at six veterinary specialist referral institutions in the UK over an 11-year period were reviewed. Data included patient signalment, physiological variables, injury-specific variables, diagnostic imaging reports, surgical procedures undertaken, duration of hospitalisation, antibiotic use, complications and outcomes...
November 10, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29122896/persistent-bacteraemia-caused-by-staphylococcus-aureus-in-the-gall-bladder
#6
Alexander Tin Han Yu, Tony Cun, Esther Benamu, Cybele Renault
Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29118839/acute-angle-closure-glaucoma-a-potential-blind-spot-in-critical-care
#7
Anna Petsas, George Chapman, Richard Stewart
We report a case of a 69-year-old gentleman who developed an acutely painful eye with loss of visual acuity whilst on the critical care unit. He was admitted three days previously with an infective exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation. In addition, he received intravenous antibiotics, steroids, nebulised bronchodilators and intravenous aminophylline, together with noradrenaline for blood pressure support. On development of visual symptoms, an emergency ophthalmology review diagnosed acute angle closure glaucoma...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29111352/use-of-antibiotics-in-paediatric-long-term-care-facilities
#8
Meghan T Murray, Candace L Johnson, Bevin Cohen, Olivia Jackson, Laney K Jones, Lisa Saiman, Elaine L Larson, Natalie Neu
BACKGROUND: Adult long term care (LTC) have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC. AIM: We sought to describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. METHODS: A retrospective cohort study was conducted September 2012 - December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAI), antimicrobial use, and diagnostic testing...
October 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29109308/triclosan-hazards-of-overuse-are-not-limited-to-antibiotics
#9
Nakul Uppal, Krishnamurthy Bonanthaya
Antibiotic abuse by patients and overprescription by some dentists are problems in modern healthcare practice. Less understood are the deleterious effects of antiseptics in oral care products marketed for routine home use. Ample literature exists to condemn the routine use of mouthrinses, but criticism focuses on alcohol content and its effects on oral mucosa.(1) We highlight the more insidious problem of triclosan, which is added as an antiseptic to toothpastes and mouthrinses.
November 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/29104430/pitfalls-in-the-diagnosis-and-management-of-invasive-pneumococcal-meningoencephalitis-what-we-can-learn-from-a-case
#10
Pascale S Grzonka, Raoul Sutter
Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29077390/lab-on-chip-devices-gaining-ground-losing-size
#11
Veronica C Romao, Sofia A M Martins, Jose Germano, Filipe A Cardoso, Susana Cardoso, Paulo P Freitas
Portable analytical devices are notably gaining relevance in the panorama of urgent testing. Such devices have the potential to play an important role as easy-to-handle tools in critical situations. Epidemic infectious disease agents (e.g., Ebola virus, Coronavirus, Zika virus) could be controlled more easily by testing travelers on-site at the country borders to prevent outbreaks from spreading. The increasing incidence of hospital-acquired infections caused by antibiotic resistant pathogens could be minimized by point-of-care microbial analysis as well as rapid screening tests of bacteria resistance...
October 27, 2017: ACS Nano
https://www.readbyqxmd.com/read/29072871/disseminated-intravascular-coagulation-in-an-under-recognised-zoonotic-infection
#12
Sarah Lawrence, Andrew Claxton, Mark Holland, Jack Hodd
A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29065395/life-threatening-atypical-case-of-acute-generalized-exanthematous-pustulosis
#13
Azadeh Tajmir-Riahi, Petra Wörl, Thomas Harrer, Stefan Schliep, Gerold Schuler, Miklos Simon
Antibiotics are known to cause severe cutaneous adverse reactions, such as the rare acute generalized exanthematous pustulosis (AGEP). Unlike Stevens-Johnson syndrome or toxic epidermal necrolysis, AGEP is rarely life-threatening. Systemic involvement is not typical, and if present usually coincides with a mild elevation of the hepatic enzymes and a decrease in renal function. Hence, AGEP is known to have a good prognosis and to be life-threatening only in elderly patients or patients with chronic diseases...
2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29058601/role-of-renal-function-in-risk-assessment-of-target-non-attainment-after-standard-dosing-of-meropenem-in-critically-ill-patients-a-prospective-observational-study
#14
Lisa Ehmann, Michael Zoller, Iris K Minichmayr, Christina Scharf, Barbara Maier, Maximilian V Schmitt, Niklas Hartung, Wilhelm Huisinga, Michael Vogeser, Lorenz Frey, Johannes Zander, Charlotte Kloft
BACKGROUND: Severe bacterial infections remain a major challenge in intensive care units because of their high prevalence and mortality. Adequate antibiotic exposure has been associated with clinical success in critically ill patients. The objective of this study was to investigate the target attainment of standard meropenem dosing in a heterogeneous critically ill population, to quantify the impact of the full renal function spectrum on meropenem exposure and target attainment, and ultimately to translate the findings into a tool for practical application...
October 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29044002/irrational-antibiotic-prescribing-practice-among-children-in-critical-care-of-tertiary-hospitals
#15
Mirza Tasawer Baig, Ali Akbar Sial, Ambreen Huma, Maryam Ahmed, Uzma Shahid, Nayel Syed
This study assessed the prescribing pattern of irrational use of antibiotic among children under age of 12 years in public and private sector hospitals in Pakistan. The prospective clinical evaluation of drug utilization pattern of antimicrobials from Patient Bedside File (PBF) of in-patients and Culture Sensitivity Test (CST) reports were evaluated to determine the antibiotic resistance. Two indicators recorded to assess antibiotic prescribing were; dose of prescribed antibiotic (low-dose, rational and high -dose) and Indication (valid or invalid)...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29033730/intentional-intra-arterial-injection-of-midazolam-in-a-patient-with-status-epilepticus-in-the-intensive-care-unit
#16
Muhammad Asghar Ali, Muhammad Yahya
Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29027654/pharmacokinetic-drug-drug-interactions-in-the-intensive-care-unit-single-centre-experience-and-literature-review
#17
Piotr Łój, Aleksanda Olender, Weronika Ślęzak, Łukasz J Krzych
BACKGROUND: Drug-drug interactions constitute a serious health hazard in everyday clinical practice in critically ill patients. Drug-drug interactions may be pharmacokinetic or pharmacodynamic in their nature. We aimed to investigate the quantity and quality of possible drug-drug interactions, and their possible side effects in intensive care unit patients in a 12-month period. METHODS: This retrospective study covered data on pharmacological treatment of 43 consecutive patients (11 females, 32 males) aged 62 ± 15 years, hospitalized between January 2015 and February 2016...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29025325/versatility-of-targeted-antibiotic-loaded-gold-nanoconstructs-for-the-treatment-of-biofilm-associated-bacterial-infections
#18
Daniel G Meeker, Tengjiao Wang, Walter N Harrington, Vladimir P Zharov, Sarah A Johnson, Samir V Jenkins, Stephanie E Oyibo, Christopher M Walker, Weston B Mills, Mark E Shirtliff, Karen E Beenken, Jingyi Chen, Mark S Smeltzer
BACKGROUND: We previously demonstrated that a photoactivatable therapeutic approach employing antibiotic-loaded, antibody-conjugated, polydopamine (PDA)-coated gold nanocages (AuNCs) could be used for the synergistic killing of bacterial cells within a biofilm. The approach was validated with a focus on Staphylococcus aureus using an antibody specific for staphylococcal protein A (Spa) and an antibiotic (daptomycin) active against Gram-positive cocci including methicillin-resistant S...
October 12, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29023567/carbapenem-resistant-enterobacteriaceae-colonization-cre-and-subsequent-risk-of-infection-and-90-day-mortality-in-critically-ill-patients-an-observational-study
#19
COMPARATIVE STUDY
Thomas Howe McConville, Sean Berger Sullivan, Angela Gomez-Simmonds, Susan Whittier, Anne-Catrin Uhlemann
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as an urgent public health threat. Intestinal colonization with CRE has been identified as a risk factor for the development of systemic CRE infection, but has not been compared to colonization with third and/or fourth generation cephalosporin-resistant (Ceph-R) Enterobacteriaceae. Moreover, the risk conferred by colonization on adverse outcomes is less clear, particularly in critically ill patients admitted to the intensive care unit (ICU)...
2017: PloS One
https://www.readbyqxmd.com/read/29022657/-shortening-the-antibiotherapy-is-in-progress-get-up-to-date
#20
Isaline Bonnemain, Heidi Sarrasin, Florie Sierro, Daniel Genné
In a world where the emergence of resistant bacteria threatens the future use of many antibiotics, it is now critical to prescribe antibiotics carefully in order to minimize selective pressure. Limiting treatment duration would be one of the strategies to achieve this goal. Recent studies state that a reduction of the course of treatment is showing great benefit with no outcome difference.
October 11, 2017: Revue Médicale Suisse
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