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https://www.readbyqxmd.com/read/28499459/dispatch-and-prehospital-transport-for-acute-septic-patients-an-observational-study
#1
Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Søren Mikkelsen, Annmarie Touborg Lassen
BACKGROUND: In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not clear in all clinical situations, some high urgency patients may end up with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28485834/profile-and-outcomes-of-women-with-pregnancy-related-acute-kidney-injury-requiring-dialysis-at-a-center-in-ethiopia
#2
Delayehu Bekele, Momina Ahmed, Ahmed Ibrahim, Seman Kedir, Grace Chan
OBJECTIVE: To describe the clinical profile and outcomes of women with pregnancy-related acute kidney injury (AKI) undergoing dialysis at Saint Paul's Hospital Millennium Medical College, Addis Ababa, where the first publicly funded large-scale dialysis service in Ethiopia was established. METHODS: In a hospital-based retrospective study, clinical records were reviewed for all women with pregnancy-related AKI attending the hemodialysis unit at the study center between August 2013 and July 2015...
May 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28470636/-antibiotic-stewardship-from-bench-to-bedside
#3
Jan R Ortlepp
The article explains the practical implementation of Antibiotic Stewardship (ABS) in the clinic. With increasing prevalence of resistant bacteria, the medical profession is challenged to critically question and reduce antibiotic prescriptions. ABS programs are designed to support this. In particular, the involvement of clinic management in the ABS has to improve. There has to be a greater awareness of problems associated with antibiotic use and the data about it must be communicated transparently within the hospital...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28461999/mulitcenter-study-on-antibiotic-prophylaxis-infectious-complications-and-risk-assessment-in-tur-p
#4
Laila Schneidewind, Jennifer Kranz, Daniel Schlager, Dimitri Barski, Sandra Mühlsteadt, Markus Grabbert, Fabian Queissert, Tanja Frank, Alexandre Egon Pelzer
INTRODUCTION: Transurethral resection of the prostate is one of the most frequent urological procedures. Urinary tract infections represent major sequelae, but data about antibiotic prophylaxis in TUR-P are controversial and outdated. MATERIAL AND METHODS: We conducted a retrospective multicentre study of TUR-P in ten German hospitals. Primary endpoints were epidemiological and outcome data of TUR-P. Secondary endpoints were the identification of factors associated with febrile UTIs and sepsis after TUR-P...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28430304/pre-ecmo-coagulopathy-does-not-increase-the-occurrence-of-hemorrhage-during-extracorporeal-support
#5
Pilar Anton-Martin, Lakshmi Raman, Nikhil Thatte, Jefferson Tweed, Vinai Modem, Janna Journeycake
INTRODUCTION AND METHODS: Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. RESULTS: Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28429310/the-protective-association-of-endogenous-immunoglobulins-against-sepsis-mortality-is-restricted-to-patients-with-moderate-organ-failure
#6
Ignacio Martin-Loeches, Arturo Muriel-Bombín, Ricard Ferrer, Antonio Artigas, Jordi Sole-Violan, Leonardo Lorente, David Andaluz-Ojeda, Adriele Prina-Mello, Ruben Herrán-Monge, Borja Suberviola, Ana Rodriguez-Fernandez, Pedro Merino, Ana M Loza, Pablo Garcia-Olivares, Eduardo Anton, Eduardo Tamayo, Wysali Trapiello, Jesús Blanco, Jesús F Bermejo-Martin
BACKGROUND: Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity. METHODS: This was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28408415/impact-of-international-quality-improvement-collaborative-on-congenital-heart-surgery-in-pakistan
#7
Amina Khan, Ahmed Abdullah, Huzaifa Ahmad, Arjumand Rizvi, Sehrish Batool, Kathy J Jenkins, Kimberlee Gauvreau, Muneer Amanullah, Anwar Haq, Nadeem Aslam, Fauzia Minai, Babar Hasan
BACKGROUND: The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. OBJECTIVES: We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. METHODS: The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD...
April 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#8
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28405984/a-prospective-study-of-acute-kidney-injury-according-to-kdigo-definition-and-its-mortality-predictors
#9
Rakesh Bhadade, Rosemarie De'Souza, Minal J Harde, Kalpana S Mehta, Prabhat Bhargava
BACKGROUND: Acute kidney injury is no longer considered to be an innocent bystander merely reflecting co-existent pathologies but an independent risk factor for mortality in the ICU. AIMS AND OBJECTIVES: To study clinical profile and correlation of patients with acute kidney injury (AKI) according to KDIGO definition with respect to incidence, outcome and different causes of AKI in critical care unit. STUDY DESIGN AND SETTING: It is a prospective observational study; and was carried out in the ICU of a tertiary care, teaching, public hospital...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28385105/icu-admission-source-as-a-predictor-of-mortality-for-patients-with-sepsis
#10
Christine A Motzkus, Stavroula A Chrysanthopoulou, Roger Luckmann, Teresa A Rincon, Kate L Lapane, Craig M Lilly
PURPOSE: Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR). METHODS: We conducted a retrospective cohort study of 1762 adults with sepsis using ICU record data obtained from a clinical database of an academic medical center...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28340860/association-of-pre-hospital-theophylline-use-and-mortality-in-chronic-obstructive-pulmonary-disease-patients-with-sepsis
#11
Yu-Ning Shih, Yung-Tai Chen, Hsi Chu, Chia-Jen Shih, Shuo-Ming Ou, Yen-Tao Hsu, Ran-Chou Chen, Sadeq A Quraishi, Imoigele P Aisiku, Raghu R Seethala, Gyorgy Frendl, Peter C Hou
BACKGROUND: Although theophylline has been shown to have anti-inflammatory effects, the therapeutic use of theophylline before sepsis is unknown. The aim of our study was to determine the effect of theophylline on COPD patients presenting with sepsis. METHODS: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients with COPD who were hospitalized for sepsis between 2000 and 2011 were divided into theophylline users and non-users...
April 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28281432/the-impact-of-a-modified-world-health-organization-surgical-safety-checklist-on-maternal-outcomes-in-a-south-african-setting-a-stratified-cluster-randomised-controlled-trial
#12
M Naidoo, J Moodley, P Gathiram, B Sartorius
BACKGROUND: In South Africa (SA), the Saving Mothers Reports have shown an alarming increase in deaths during or after caesarean delivery. OBJECTIVE: To improve maternal surgical safety in KwaZulu-Natal Province, SA, by implementing the modified World Health Organization surgical safety checklist for maternity care (MSSCL) in maternity operating theatres. METHODS: The study was a stratified cluster-randomised controlled trial conducted from March to November 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28260772/neonatal-transport-experience-of-a-tertiary-care-hospital-of-bangladesh
#13
S K Dey, S Sharker, I Jahan, S C Moni, K H Shabuj, M J Chisti, M A Mannan, M Shahidullah
Safe transportation is mostly an unnoticed neonatal health issue in Bangladesh and no documentation is available regarding the existing practices. So this study was intended to document transport status of the referred newborn to a tertiary care hospital. This observational study included 150 out born neonates over 12 months period transported from various places to NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU) from May 2015 to April 2016. A structured data collection form was used to record information categorized into pre-transport, during transport and at admission...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28248851/acute-kidney-injury-in-patients-with-pulmonary-embolism-a-population-based-cohort-study
#14
Chih-Hsiang Chang, Chung-Ming Fu, Pei-Chun Fan, Shao-Wei Chen, Su-Wei Chang, Chun-Tai Mao, Ya-Chung Tian, Yung-Chang Chen, Pao-Hsien Chu, Tien-Hsing Chen
Acute kidney injury (AKI) is overlooked in patients with pulmonary embolism (PE). Risk factors for and long-term outcomes of this complication remain unknown. This study evaluated the predictors and prognosis of AKI in patients with PE.This retrospective cohort study used Taiwan's National Health Insurance Research Database. We enrolled a total of 7588 patients who were admitted to a hospital for PE from January1997 to December 2011 and administered anticoagulation or thrombolytic agents. All demographic data, risk factors, and outcomes were analyzed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#15
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#16
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#17
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28161425/the-rise-and-fall-of-pneumococcal-serotypes-carried-in-the-pcv-era
#18
Vanessa T Devine, David W Cleary, Johanna M C Jefferies, Rebecca Anderson, Denise E Morris, Andrew C Tuck, Rebecca A Gladstone, Grace O'Doherty, Priyasharmila Kuruparan, Stephen D Bentley, Saul N Faust, Stuart C Clarke
Streptococcus pneumoniae is a major cause of meningitis, sepsis and pneumonia worldwide. Vaccination using pneumococcal conjugate vaccines (PCV) has therefore been part of the UK's childhood immunisation programme since 2006. Here we describe pneumococcal carriage rates in children under five years of age attending the paediatric department of a large UK hospital in response to vaccine implementation over seven winter seasons from 2006 to 2013. S. pneumoniae (n=696) were isolated from nasopharyngeal swabs (n=2267) collected during seven consecutive winters, October to March, 2006/7 to 2012/13...
February 1, 2017: Vaccine
https://www.readbyqxmd.com/read/28146099/pediatric%C3%A2-mortality%C3%A2-in%C3%A2-a%C3%A2-rural%C3%A2-tertiary%C3%A2-care%C3%A2-center-in%C3%A2-liberia
#19
Carmelle Tsai, Camila B Walters, John Sampson, Francis Kateh, Mary P Chang
Liberia is a low-income country in West Africa that has faced significant challenges, including a civil war and the recent Ebola epidemic. Little data exists on the more current post-war and pre-Ebola trends of child health in Liberia in the rural setting. This study is a retrospective chart review of pediatric mortality in 2013 at a rural tertiary care center in Liberia, 10 years post-war. From January 2013 to December 2013, there were 50 pediatric deaths, or 5.4% of the 920 total pediatric admissions. The most common cause of neonatal death was sepsis, and the most common cause of death under five years of age was malaria...
January 30, 2017: Children
https://www.readbyqxmd.com/read/28128518/maternal-and-neonatal-outcomes-in-women-with-severe-early-onset-pre-eclampsia-before-26-weeks-of-gestation-a-case-series
#20
M F van Oostwaard, L van Eerden, M W de Laat, J J Duvekot, Jjhm Erwich, Kwm Bloemenkamp, A C Bolte, Jpf Bosma, S V Koenen, R F Kornelisse, B Rethans, P van Runnard Heimel, Hcj Scheepers, W Ganzevoort, Bwj Mol, C J de Groot, Ipm Gaugler-Senden
OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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