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https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#1
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28069905/evaluation-of-the-threshold-value-for-the-modified-early-warning-score-mews-in-medical-septic-patients-a-secondary-analysis-of-an-italian-multicentric-prospective-cohort-snoopii-study
#2
Daniela Tirotta, Maurizia Gambacorta, La Regina Micaela, Tiziana Attardo, Lo Gullo Alberto, Filomena Panzone, Mazzone Antonino, Campanini Mauro, Francesco Dentali
BACKGROUND: Due to aging and resources limitation, septic patients are often admitted to medical wards (MWs). Early warning deterioration is a relevant issue in this setting. Unfortunately, a suitable prognostic score has not been identified, yet. AIM: To explore the ability of Modified Early Warning Score (MEWS) to predict the in-hospital mortality in septic patients admitted to MWs. DESIGN SECONDARY ANALYSIS OF A MULTICENTRIC PROSPECTIVE STUDY: Methods: Consecutive septic patients with positive blood culture admitted to 31 Italian MWs were included...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28029501/declining-mortality-due-to-severe-sepsis-and-septic-shock-in-spanish-intensive-care-units-a-two-cohort-study-in-2005-and-2011
#3
B Sánchez, R Ferrer, D Suarez, E Romay, E Piacentini, G Gomà, M L Martínez, A Artigas
OBJECTIVE: To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care. DESIGN: A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group)...
October 28, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27927604/factors-predicting-failure-of-noninvasive-ventilation-assist-for-preventing-reintubation-among-medical-critically-ill-patients
#4
Preecha Thomrongpairoj, Surat Tongyoo, Withaya Tragulmongkol, Chairat Permpikul
PURPOSE: Reintubation after failed extubation is associated with high mortality. Noninvasive ventilation (NIV) has been used to prevent reintubation, but the results have been inconclusive. We investigated the factors predicting failure of NIV-assisted extubation among medical critically ill patients. MATERIALS AND METHODS: This retrospective cohort study enrolled patients who were admitted to medical intensive care units at Siriraj Hospital between March 2012 and August 2015 who required more than 48 hours of mechanical ventilation and who received NIV after endotracheal extubation...
November 30, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27876594/successful-control-of-a-large-outbreak-of-hiv-infection-associated-with-injection-of-cathinone-derivatives-in-tel-aviv-israel
#5
Eugene Katchman, Ronen Ben-Ami, Michal Savyon, Daniel Chemtob, Boaz Avidor, Asaf Wasserman, Irena Zeldis, Shirley Girshengorn, Ziva Amitai, Rivka Sheffer, Dan Turner
OBJECTIVES: Outbreaks of HIV infection have been linked to injectable drug abuse, but specific triggers often remain obscure. We report on an outbreak of primary HIV infection among people who inject drugs (PWID) in Tel Aviv, associated with a local shift in drug-use practices. METHODS: A cluster of primary HIV infection cases in PWID was detected in May 2012. Retrospective and prospective multi-hospital case finding was initiated. PWID were interviewed and risk factors for primary HIV infection were identified...
November 19, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27876013/reduced-neonatal-mortality-in-a-regional-hospital-in-mozambique-linked-to-a-quality-improvement-intervention
#6
Maria Elena Cavicchiolo, Paolo Lanzoni, Mazungo Olivier Wingi, Damiano Pizzol, Marco Daverio, Liviana Da Dalt, Giovanni Putoto, Daniele Trevisanuto
BACKGROUND: Neonatal mortality remains a serious health issue especially in low resource countries, where 99% of neonatal deaths occur. Doctors with Africa CUAMM is an Italian non-governmental organization in the field of healthcare that has been working in Africa since 1955. In Mozambique, at the Central Beira Hospital (CBH), it has a project with the aim of supporting the neonatal intensive care unit (NICU) and the Obstetrical Department of the CBH through a multi-level intervention...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27855722/prognostic-impact-of-restored-sinus-rhythm-in-patients-with-sepsis-and-new-onset-atrial-fibrillation
#7
Wen Cheng Liu, Wen Yu Lin, Chin Sheng Lin, Han Bin Huang, Tzu Chiao Lin, Shu Meng Cheng, Shih Ping Yang, Jung Chung Lin, Wei Shiang Lin
BACKGROUND: New-onset atrial fibrillation (NeOAF) is a common type of tachyarrhythmia in critically ill patients and is associated with increased mortality in patients with sepsis. However, the prognostic impact of restored sinus rhythm (SR) in septic patients with NeOAF remains unclear. METHODS: A total of 791 patients with sepsis, who were admitted to a medical intensive care unit from January 2011 to January 2014, were screened. NeOAF was detected by continuous electrocardiographic monitoring...
November 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27836310/effects-of-perioperative-supplementation-with-pro-synbiotics-on-clinical-outcomes-in-surgical-patients-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#8
Xiang-Dong Wu, Meng-Meng Liu, Xi Liang, Ning Hu, Wei Huang
BACKGROUND & AIMS: The Potential benefits and possible risks of perioperative supplementation with probiotics/synbiotics in surgical patients are not fully understood. Recent evidence has rapidly evolved and conveys conflicting results. Thus, we undertook a meta-analysis of randomized controlled trials (RCTs) to valuate the effectiveness, safety, cost-effectiveness and quality of life of perioperative supplementation with pro-/synbiotics. METHODS: We systematically searched PubMed, Embase and the Cochrane Library through October 2015 to identify RCTs that assessed the effects of perioperative supplementation with pro-/synbiotics in surgical patients...
October 26, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27771026/impact-of-the-implementation-of-a-sepsis-code-hospital-protocol-in-antibiotic-prescription-and-clinical-outcomes-in-an-intensive-care-unit
#9
L García-López, S Grau-Cerrato, A de Frutos-Soto, F Bobillo-De Lamo, R Cítores-Gónzalez, F Diez-Gutierrez, M F Muñoz-Moreno, T Sánchez-Sánchez, F Gandía-Martínez, D Andaluz-Ojeda
INTRODUCTION: A study was performed to analyze the impact of an in-hospital Sepsis Code (SC) program on use of antibiotic and clinical outcomes. DESIGN: Quasi-experimental observational retrospective study. SETTING: Polyvalent 11 beds ICU belonging to a tertiary Universitary hospital. PATIENTS: Patients admitted consecutively to the ICU with diagnosis of severe sepsis or septic shock. INTERVENTIONS: A post intervention group (POST-SC) (September 2012-August 2013) was compared with a historical group (PRE-SC) used as control (January-December 2010)...
October 19, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27770512/serious-maternal-complications-in-relation-to-severe-pre-eclampsia-a-retrospective-cohort-study-of-the-impact-of-hospital-volume
#10
C V Ananth, J A Lavery, A M Friedman, R J Wapner, J D Wright
OBJECTIVE: We examined rates of serious maternal complications in relation to severe pre-eclampsia based on the delivering hospital's annualised volume. DESIGN: Retrospective cohort study. POPULATION AND SETTING: Singleton deliveries (n = 25 782 235) in 439 hospitals in the USA. METHODS: Annualised hospital volume was categorised as 25-500, 501-1000, 1001-2000 and >2000. MAIN OUTCOME MEASURES: Rates of in-hospital maternal death and serious maternal complications, including puerperal cerebrovascular disorders, pulmonary oedema, disseminated intravascular coagulation, acute renal, heart and liver failure, sepsis, haemorrhage and intubation in relation to severe pre-eclampsia...
October 21, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27752186/approach-to-an-obstetric-prognosis-scale-the-modified-sofa-scale
#11
Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
https://www.readbyqxmd.com/read/27692951/predictors-of-survival-in-adults-undergoing-extracorporeal-membrane-oxygenation-with-severe-infections
#12
Aristine Cheng, Hsin-Yun Sun, Mao-Song Tsai, Wen-Je Ko, Pi-Ru Tsai, Fu-Chang Hu, Yee-Chun Chen, Shan-Chwen Chang
BACKGROUND: To identify novel factors associated with the survival of septic adults receiving extracorporeal membrane oxygenation (ECMO) to improve patient selection and outcomes. METHODS: Cases were identified from our ECMO registry from 2001 to 2011 if they were ≥16 years and received ECMO for life-threatening sepsis. RESULTS: A total of 151 adults with a median (25th-75th percentile) age of 51 (37-63) years were analyzed. Pneumonia (50%), myocarditis (20%), and primary bloodstream infections (15%) were the main types of infection, caused by predominantly nonfermentative Gram-negative bacteria (NFGNB) (26%), Enterobacteriaceae (24%), and Gram-positive cocci (21%)...
December 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27663180/clinical-predictors-of-hospital-mortality-differ-between-direct-and-indirect-acute-respiratory-distress-syndrome
#13
Liang Luo, Ciara M Shaver, Zhiguo Zhao, Tatsuki Koyama, Carolyn S Calfee, Julie A Bastarache, Lorraine B Ware
BACKGROUND: Direct (pulmonary) and indirect (extrapulmonary) ARDS are distinct syndromes with important pathophysiologic differences. The goal of this study was to determine whether clinical characteristics and predictors of mortality differ between direct or indirect ARDS. METHODS: A retrospective observational cohort study of 417 ARDS patients. Each patient was classified as having direct (pneumonia or aspiration, n=250) or indirect ARDS (non-pulmonary sepsis or pancreatitis, n=167)...
September 20, 2016: Chest
https://www.readbyqxmd.com/read/27663108/the-association-of-unipolar-depression-with-thirty-day-mortality-after-hospitalization-for-infection-a-population-based-cohort-study-in-denmark
#14
Dimitry S Davydow, Anette Riisgaard Ribe, Henrik Søndergaard Pedersen, Mogens Vestergaard, Morten Fenger-Grøn
OBJECTIVE: While depression is associated with higher risk of death due to chronic medical conditions, it is unknown if depression increases mortality following serious infections. We sought to determine if pre-existing unipolar depression is associated with increased mortality within 30days after hospitalization for a serious infection. METHODS: We conducted a population-based cohort study of all adults hospitalized for an infection in Denmark between 2005 and 2013...
October 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27608524/implementation-of-an-emergency-department-sepsis-bundle-and-system-redesign-a-process-improvement-initiative
#15
Tamara McColl, Mathieu Gatien, Lisa Calder, Krishan Yadav, Ryan Tam, Melody Ong, Monica Taljaard, Ian Stiell
BACKGROUND: In 2008-2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol...
September 9, 2016: CJEM
https://www.readbyqxmd.com/read/27583356/sepsis-complicated-by-brain-abscess-following-eswl-of-a-caliceal-kidney-stone-a-case-report
#16
Alessandro Capitanini, Luca Rosso, Laura Giannecchini, Ophelia Meniconi, Adamasco Cupisti
A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred...
September 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27583208/fatal-purpura-fulminans-and-waterhouse-friderichsen-syndrome-from-fulminant-streptococcus-pneumoniae-sepsis-in-an-asplenic-young-adult
#17
Andrew J Hale, Mary LaSalvia, James E Kirby, Allison Kimball, Rachel Baden
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock...
2016: IDCases
https://www.readbyqxmd.com/read/27533903/classification-of-soft-tissue-injuries-in-open-femur-fractures-relevant-for-systemic-complications
#18
Christian David Weber, Rolf Lefering, Thomas Dienstknecht, Philipp Kobbe, Richard Martin Sellei, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND: A broad range of systemic complications has been described to occur in patients with open major fractures. Various causes have been claimed to play a role. We therefore surveyed a nationwide trauma registry to assess risk factors associated with closed and various types of open femur fractures. METHODS: This was a cohort study in a nationwide population-based prospective database. Inclusion criteria for selection from database are as follows: individuals with femur fracture, age 16 years or older, and survival until primary admission...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27528853/incidence-and-risk-factors-for-30-day-readmissions-after-hip-fracture-surgery
#19
Christopher T Martin, Yubo Gao, Andrew J Pugely
BACKGROUND: Unplanned hospital readmission following orthopedic procedures results in significant expenditures for the Medicare population. In order to reduce expenditures, hospital readmission has become an important quality metric for Medicare patients. The purpose of the present study is to determine the incidence and risk factors for 30-day readmissions after hip fracture surgery. METHODS: Patients over the age of 18 years who underwent hip fracture surgery, including open reduction internal fixation (ORIF), intramedullary nailing, hemi-arthroplasty, or total hip arthroplasty, between the years 2012 and 2013 were identified from the American College of Surgeons National Surgical Quality improvement Program (NSQIP) database...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27499412/feasibility-of-pulse-oximetry-pre-discharge-screening-implementation-for-detecting-critical-congenital-heart-lesions-in-newborns-in-a-secondary-level-maternity-hospital-in-the-western-cape-south-africa-the-popsicle-study
#20
A M Van Niekerk, R M Cullis, L L Linley, L Zühlke
BACKGROUND: Early detection of critical congenital heart disease (CCHD) through newborn pulse oximetry (POx) screening is an effective strategy for reducing paediatric morbidity and mortality rates and has been adopted by much of the developed world. OBJECTIVES: To document the feasibility of implementing pre-discharge POx screening in well babies born at Mowbray Maternity Hospital, a busy government hospital in Cape Town, South Africa. Parent and staff acceptance was assessed...
August 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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