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https://www.readbyqxmd.com/read/29788443/pediatric-infectious-diseases-meets-the-future
#1
Janet R Gilsdorf, Paul Spearman, Janet A Englund, Tina Q Tan, Kristina A Bryant
Pediatric infectious diseases physicians are dedicated to the diagnosis, prevention, and management of infections in children. As such, we play large, and important, roles in the clinical care of children from birth to late adolescence and in infection prevention, antimicrobial stewardship, research pertaining to infections, public health, international and global health, and advocacy for children's health. Furthermore, we are critical to the education of future physicians (in general), pediatricians, and infectious diseases doctors...
May 19, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29783252/the-analytical-prognosis-of-the-susceptibility-to-aminoglycosides-and-doxycycline-inacinetobacter-baumanniiisoolated-from-burns-of-intensive-care-unit-patients
#2
Vasyl I Nahaichuk, Oleksandr A Nazarchuk, Neonila I Osadchuk, Dmytro V Dmytriiev, Halyna H Nazarchuk
OBJECTIVE: Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782199/bacteriolysis-a-mere-laboratory-curiosity
#3
Isaac Ginsburg, Erez Koren
The role of bacteriolysis in the pathophysiology of microbial infections dates back to 1893 when Buchner and Pfeiffer reported for the first time the lysis of bacteria by immune serum and related this phenomenon to the immune response. Later on, basic anti-microbial peptides and certain beta-lactam antibiotics have been shown not only to kill microorganisms but also to induce bacteriolysis and the release of cell-wall components. In 2009, a novel paradigm was offered suggesting that the main cause of death in sepsis is due to the exclusive release from activated human phagocytic neutrophils (PMNs) traps adhering upon endothelial cells of highly toxic nuclear histone...
May 21, 2018: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/29767829/homeopathy-in-the-age-of-antimicrobial-resistance-is-it-a-viable-treatment-for-upper-respiratory-tract-infections
#4
Alison Fixsen
BACKGROUND:  Acute upper respiratory tract infections (URTIs) and their complications are the most frequent cause of antibiotic prescribing in primary care. With multi-resistant organisms proliferating, appropriate alternative treatments to these conditions are urgently required. Homeopathy presents one solution; however, there are many methods of homeopathic prescribing. This review of the literature considers firstly whether homeopathy offers a viable alternative therapeutic solution for acute URTIs and their complications, and secondly how such homeopathic intervention might take place...
May 2018: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#5
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#6
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29763469/rapid-diagnosis-of-bloodstream-infections-in-the-critically-ill-evaluation-of-the-broad-range-pcr-esi-ms-technology
#7
Martina Tassinari, Silvia Zannoli, Patrizia Farabegoli, Maria Federica Pedna, Anna Pierro, Antonio Mastroianni, Riccardo Fontan, Luciano Luongo, Giuseppe Sarnataro, Elisa Menegatti, Assunta Caruso, Vittorio Sambri
Bloodstream infection (BSI) and associated sepsis represent a major source of mortality in industrialized countries. Prompt treatment with targeted antibiotics affects both the financial impact and the clinical outcome of BSI: every hour gained in initiating the correct antimicrobial therapy significantly increases the probability of patient survival. However, the current standard-of-care, which depends on blood culture-based diagnosis, are often unable to provide such a fast response. Fast and sensitive molecular techniques for the detection of sepsis-related pathogens from primary blood samples are strongly needed...
2018: PloS One
https://www.readbyqxmd.com/read/29757882/american-association-of-nurse-practitioners-national-nurse-practitioner-sample-survey-update-on-acute-care-nurse-practitioner-practice
#8
Ruth Kleinpell, Michelle L Cook, Diane L Padden
BACKGROUND AND PURPOSE: Data from national surveys on the practice of nurse practitioners (NPs) provides valuable information on aspects of practice, demographic characteristics of providers and patients, plans for continued employment, and role satisfaction. The American Association of Nurse Practitioners (AANP) has been conducting the AANP Sample Survey since 1988. METHODS: The most recent AANP Sample Survey was conducted in 2016 with a random stratified survey of 40,000 NPs...
March 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29746711/a-monte-carlo-simulation-approach-for-beta-lactam-dosing-in-critically-ill-patients-receiving-prolonged-intermittent-renal-replacement-therapy
#9
Soo Min Jang, Katherine N Gharibian, Susan J Lewis, William H Fissell, Ashita J Tolwani, Bruce A Mueller
Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4 L/h × 10 hours or 5 L/h × 8 hours in hemodialysis and hemofiltration modes)...
May 10, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#10
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29735833/echinocandins-their-role-in-the-management-of-candida-biofilms
#11
Subramanian Swaminathan, Shweta Kamat, Nalini Adele Pinto
The importance of antifungal agents and their clinical implications has received little attention in comparison to antibiotics, particularly in the health-care setting. However, apart from bacterial infections rising in hospitals, the incidences of fungal infections are growing with the development of resistance to conventional antifungal agents. Newer antifungal agents such as echinocandins (ECs) have been extensively studied over the past decade and are recognised as a superior treatment compared with prior antifungals as a first line of therapy in tertiary institutions...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29732182/drugs-pharmacokinetics-during-veno-venous-extracorporeal-membrane-oxygenation-in-pediatrics
#12
REVIEW
Matteo Di Nardo, Enno Diederick Wildschut
Data evaluating pharmacokinetic/pharmacodynamic (PK/PD) aspect in the pediatric population are scarce especially regarding the pediatric intensive care unit. Dosing of frequently used drugs (sedatives, analgesics, antibiotics and cardiovascular drugs) are mainly based on non "pediatric intensive care unit (PICU)" patients, and sometimes are translated from adult patients. Among PICU patients, the most complex patients are the ones who are critically ill and are receiving mechanical circulatory/respiratory support for cardiac and/or respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#13
Javed Ismail, M Jayashree
Septic shock in children is associated with high mortality, especially in developing countries. Management includes early recognition, timely antibiotics, aggressive fluid resuscitation, and appropriate vasoactive therapy, to achieve the therapeutic end points. The evidence at each step in management has evolved over the past decade with a paradigm shift in emphasis from a 'protocolized care' to an 'individualized physiology-based care'. This shift mirrors the general trend one observes in critical care with respect to various treatment modalities i...
April 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29722812/antibiotics-in-ibd-still-a-role-in-the-biological-era
#14
Oren Ledder, Dan Turner
Despite compelling evidence pointing to a critical role of gut microflora in inflammatory bowel disease (IBD) pathogenesis, the role of antibiotics in clinical practice remains limited, largely due to heterogeneous trials with often conflicting evidence. In this review, we revisit previous randomized controlled trials and high-quality uncontrolled studies in an effort to better elucidate the role of antibiotics in contemporary treatment algorithms. The most established role of antibiotics is in perianal Crohn's disease (CD), utilizing ciprofloxacin with or without metronidazole often as an adjunct to biological therapy...
May 2, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29704547/predictive-performance-of-a-gentamicin-population-pharmacokinetic-model-in-two-western-populations-of-critically-ill-patients
#15
Laura H Bukkems, Claire Roger, Caspar J Hodiamont, Jean-Yves Lefrant, Nicole P Juffermans, Jason A Roberts, Reinier M van Hest
: Before population pharmacokinetic (PK) models can be clinically applied to aid in dose selection of antibiotics, external validation of the model is warranted. The aim of this study was to assess the predictive performance of a gentamicin population PK model in intensive care unit (ICU) patients in two independent populations of Western critically ill patients. METHODS: Data from the same ICU as used for the earlier model development (Academic Medical Centre, Amsterdam (AMC)) and from the Centre Hospitalier Universitaire de Nîmes (CHU Nîmes) were collected...
April 25, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#16
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29669670/utilization-and-timeliness-of-an-inpatient-penicillin-allergy-evaluation
#17
Keith A Sacco, Razvan Chirila, Claudia Libertin, Brett Hiroto, Arveen Bhasin, Margaret M Johnson, Thanai Pongdee, M Caroline Burton
BACKGROUND: A history of penicillin allergy is associated with an increased risk of nosocomial infections because patients are exposed to non-beta lactam antibiotics. Ruling out inaccurate penicillin allergy during hospitalization decreases prescription of beta lactam antibiotics. However, the utilization of penicillin allergy testing and timeliness in relation to initiation of antibiotics is not known. OBJECTIVE: Our aim was to describe the proportion and characteristics of patients who underwent inpatient penicillin allergy testing in a hospital without a guideline or infrastructure for inpatient penicillin allergy testing...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29665444/ndm-1-and-oxa-23-producing-acinetobacter-baumannii-isolated-from-intensive-care-unit-patients-in-tunisia
#18
Elaa Maamar, Carla Andrea Alonso, Sana Ferjani, Ali Jendoubi, Zaineb Hamzaoui, Alia Jebri, Mabrouka Saidani, Salma Ghedira, Carmen Torres, Ilhem Boutiba-Ben Boubaker
Gastrointestinal colonization by carbapenem-resistant Acinetobacter baumannii (CRAB), is a critical step before nosocomial infection. Our objective was to evaluate CRAB intestinal carriage in patients admitted in the intensive care unit (ICU) of a Tunisian Hospital and to determine the antimicrobial resistance mechanisms involved. From December-2014 to February-2015, all 63 patients admitted at the ICU were screened for rectal CRAB-colonization upon admission and once weekly thereafter. ICU-patients who acquired a CRAB-nosocomial-infection were also included...
April 14, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29659359/-pneumonia-associated-with-mechanical-ventilation-update-and-recommendations-inter-societies-sadi-sati
#19
Wanda Cornistein, Ángel M Colque, María Inés Staneloni, María Monserrat Lloria, Mónica Lares, Ana Laura González, Alejandro Fernández Garcés, Edith Carbone
Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP...
2018: Medicina
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#20
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
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